A MAJOR long-term study has revealed that people living with chronic obstructive pulmonary disease (COPD) and chronic respiratory failure (CRF) are at significantly higher risk of developing cardiovascular diseases (CVD), and that these conditions occur earlier than in COPD patients without respiratory failure.
The fifteen-year retrospective cohort study, conducted using data from the TriNetX Analytics Network, included 246,712 adults with COPD, divided evenly into two matched groups: those with both COPD and CRF, and those with COPD alone. Participants were matched for age, body mass index (BMI), and sex to ensure comparable risk profiles.
Researchers examined the timing and incidence of three major cardiovascular conditions: ischemic heart disease (IHD), congestive heart failure (CHF), and cardiac atrial arrhythmia (CAA), following a COPD diagnosis. Participants who had already experienced that disease before the study began were excluded, ensuring that only new cases were counted. Using advanced statistical modelling, they tracked the likelihood of participants remaining free from these heart diseases over 15 years.
Timing and Risk Differences
After 15 years, significant disparities emerged. Among COPD patients with CRF, only 38.5% remained free from IHD, 27.9% from CHF, and 57.6% from CAA. In comparison, COPD patients without CRF fared better, with 42.5%, 43.5%, and 65.9% remaining unaffected, respectively, which are all statistically significant differences (p < 0.0001).
These findings indicate that cardiovascular complications not only occur more frequently but also develop earlier in patients whose COPD is complicated by chronic respiratory failure.
Implications for Screening and Care for COPD Patients
The study’s authors caution that, while retrospective in nature, the results underscore a clear clinical message: targeted cardiovascular screening and close monitoring are crucial for COPD patients with CRF. Early identification of heart-related risks could enable more timely interventions and potentially reduce morbidity and mortality in this population.
Reference
Vitacca M et al. Timing of cardiovascular events in people with COPD with and without chronic respiratory failure. Respir Med. 2025;108429.
