Increased risk of community-acquired pneumonia in COPD patients with comorbid cardiovascular disease

• Published in: International journal of chronic obstructive pulmonary disease Vol. 11; no. 1; pp. 3051 - 3058
• Main Authors: Lin, Sheng-Hao, Perng, Diahn-Warng, Chen, Ching-Pei, Chai, Woei-Horng, Yeh, Chin-Shui, Kor, Chew-Teng, Cheng, Shih-Lung, Chen, Jeremy Jw, Lin, Ching-Hsiung
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2016; Dove Medical Press Ltd; Dove Medical Press
• Subjects: Administration, Inhalation; Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - adverse effects; Aged; Aged, 80 and over; Body mass index; Bronchodilator Agents - administration & dosage; Bronchodilator Agents - adverse effects; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Care and treatment; Chi-Square Distribution; Chronic illnesses; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease (COPD); Community-acquired infections; Community-Acquired Infections - diagnosis; Community-Acquired Infections - epidemiology; community-acquired pneumonia; Comorbidity; Development and progression; Diabetes; Female; Heart failure; Humans; Incidence; inhaled-corticosteroids; Intensive care; Kaplan-Meier Estimate; Lung cancer; Male; Medical imaging; Medical Records; Middle Aged; Mortality; Multivariate Analysis; Original Research; Patients; Physiological aspects; Pneumonia; Pneumonia - diagnosis; Pneumonia - epidemiology; Proportional Hazards Models; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - epidemiology; Retrospective Studies; Risk Assessment; Risk Factors; Steroids; Taiwan - epidemiology; Tomography; Tuberculosis; CVD; cardiovascular disease; CAP; community-acquired pneumonia; COPD; chronic obstructive pulmonary disease; inhaled corticosteroids
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S115137

COPD patients with community-acquired pneumonia (CAP) have worse clinical outcomes, as compared to those without COPD. Cardiovascular disease (CVD) is a common comorbidity for COPD patients. Whether COPD with comorbid CVD will increase the risk of CAP is not well investigated. The incidence and factors associated with CAP in COPD patients with and without CVD were analyzed. The medical records of patients with newly diagnosed COPD between 2007 and 2010 were reviewed. The patients' characteristics, medical history of CVD, occurrence of CAP, and type of medication were recorded. Kaplan-Meier curves were used to assess the differences in cumulative incidence of CAP. Cox's proportional hazards regression model was used to determine the adjusted hazard ratios with 95% confidence intervals in relation to factors associated with CAP in COPD patients with and without CVD. Among 2,440 patients, 475 patients (19.5%) developed CAP during the follow-up period. COPD patients who developed CAP were significantly older, had lower forced expiratory volume in 1 second, frequent severe exacerbation and comorbid CVD, as well as received inhaled corticosteroid (ICS)-containing therapy than those without CAP. The cumulative incidence of CAP was higher in COPD patients with CVD compared to those without CVD. Patients who received ICS-containing therapy had significantly increased risk of developing CAP compared to those who did not. For patients with COPD, comorbid CVD is an independent risk factor for developing CAP. ICS-containing therapy may increase the risk of CAP among COPD patients.