Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis
Objectives Cardiovascular disease is an important comorbidity in patients with chronic obstructive pulmonary disease (COPD). We aimed to systematically review the evidence for: (1) risk of myocardial infarction (MI) in people with COPD; (2) risk of MI associated with acute exacerbation of COPD (AECO...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2015-09-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/5/9/e007824.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1825206924961906688 |
|---|---|
| author | Jennifer K Quint Liam Smeeth Kieran J Rothnie Ruoling Yan |
| author_facet | Jennifer K Quint Liam Smeeth Kieran J Rothnie Ruoling Yan |
| author_sort | Jennifer K Quint |
| collection | DOAJ |
| description | Objectives Cardiovascular disease is an important comorbidity in patients with chronic obstructive pulmonary disease (COPD). We aimed to systematically review the evidence for: (1) risk of myocardial infarction (MI) in people with COPD; (2) risk of MI associated with acute exacerbation of COPD (AECOPD); (3) risk of death after MI in people with COPD.Design Systematic review and meta-analysis.Methods MEDLINE, EMBASE and SCI were searched up to January 2015. Two reviewers screened abstracts and full text records, extracted data and assessed studies for risk of bias. We used the generic inverse variance method to pool effect estimates, where possible. Evidence was synthesised in a narrative review where meta-analysis was not possible.Results Searches yielded 8362 records, and 24 observational studies were included. Meta-analysis showed increased risk of MI associated with COPD (HR 1.72, 95% CI 1.22 to 2.42) for cohort analyses, but not in case–control studies: OR 1.18 (0.80 to 1.76). Both included studies that investigated the risk of MI associated with AECOPD found an increased risk of MI after AECOPD (incidence rate ratios, IRR 2.27, 1.10 to 4.70, and IRR 13.04, 1.71 to 99.7). Meta-analysis showed weak evidence for increased risk of death for patients with COPD in hospital after MI (OR 1.13, 0.97 to 1.31). However, meta-analysis showed an increased risk of death after MI for patients with COPD during follow-up (HR 1.26, 1.13 to 1.40).Conclusions There is good evidence that COPD is associated with increased risk of MI; however, it is unclear to what extent this association is due to smoking status. There is some evidence that the risk of MI is higher during AECOPD than stable periods. There is poor evidence that COPD is associated with increased in hospital mortality after an MI, and good evidence that longer term mortality is higher for patients with COPD after an MI. |
| format | Article |
| id | doaj-art-13636fc6274c4c1fae35d20acd0e0f83 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2015-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-13636fc6274c4c1fae35d20acd0e0f832025-02-07T01:10:09ZengBMJ Publishing GroupBMJ Open2044-60552015-09-015910.1136/bmjopen-2015-007824Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysisJennifer K Quint0Liam Smeeth1Kieran J Rothnie2Ruoling Yan3Imperial College London, London, UK2Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK1 Value Evidence and Outcomes, R&D Global Medical, GlaxoSmithKline, London, UK3Medical School, Faculty of Medical Sciences, University College London, London, UKObjectives Cardiovascular disease is an important comorbidity in patients with chronic obstructive pulmonary disease (COPD). We aimed to systematically review the evidence for: (1) risk of myocardial infarction (MI) in people with COPD; (2) risk of MI associated with acute exacerbation of COPD (AECOPD); (3) risk of death after MI in people with COPD.Design Systematic review and meta-analysis.Methods MEDLINE, EMBASE and SCI were searched up to January 2015. Two reviewers screened abstracts and full text records, extracted data and assessed studies for risk of bias. We used the generic inverse variance method to pool effect estimates, where possible. Evidence was synthesised in a narrative review where meta-analysis was not possible.Results Searches yielded 8362 records, and 24 observational studies were included. Meta-analysis showed increased risk of MI associated with COPD (HR 1.72, 95% CI 1.22 to 2.42) for cohort analyses, but not in case–control studies: OR 1.18 (0.80 to 1.76). Both included studies that investigated the risk of MI associated with AECOPD found an increased risk of MI after AECOPD (incidence rate ratios, IRR 2.27, 1.10 to 4.70, and IRR 13.04, 1.71 to 99.7). Meta-analysis showed weak evidence for increased risk of death for patients with COPD in hospital after MI (OR 1.13, 0.97 to 1.31). However, meta-analysis showed an increased risk of death after MI for patients with COPD during follow-up (HR 1.26, 1.13 to 1.40).Conclusions There is good evidence that COPD is associated with increased risk of MI; however, it is unclear to what extent this association is due to smoking status. There is some evidence that the risk of MI is higher during AECOPD than stable periods. There is poor evidence that COPD is associated with increased in hospital mortality after an MI, and good evidence that longer term mortality is higher for patients with COPD after an MI.https://bmjopen.bmj.com/content/5/9/e007824.full |
| spellingShingle | Jennifer K Quint Liam Smeeth Kieran J Rothnie Ruoling Yan Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis BMJ Open |
| title | Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis |
| title_full | Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis |
| title_fullStr | Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis |
| title_full_unstemmed | Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis |
| title_short | Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis |
| title_sort | risk of myocardial infarction mi and death following mi in people with chronic obstructive pulmonary disease copd a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/5/9/e007824.full |
| work_keys_str_mv | AT jenniferkquint riskofmyocardialinfarctionmianddeathfollowingmiinpeoplewithchronicobstructivepulmonarydiseasecopdasystematicreviewandmetaanalysis AT liamsmeeth riskofmyocardialinfarctionmianddeathfollowingmiinpeoplewithchronicobstructivepulmonarydiseasecopdasystematicreviewandmetaanalysis AT kieranjrothnie riskofmyocardialinfarctionmianddeathfollowingmiinpeoplewithchronicobstructivepulmonarydiseasecopdasystematicreviewandmetaanalysis AT ruolingyan riskofmyocardialinfarctionmianddeathfollowingmiinpeoplewithchronicobstructivepulmonarydiseasecopdasystematicreviewandmetaanalysis |