Evidence map›Paper›PMID 26893553›Full record

ArticleInternational journal of chronic obstructive pulmonary disease2016

No association between exacerbation frequency and stroke in patients with COPD.

Claire Windsor, Emily Herrett, Liam Smeeth, Jennifer Kathleen Quint

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of chronic obstructive pulmonary disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Accelerated FEVThe European respiratory journal · 2021
    Article
  6. Insights into Chronic Obstructive Pulmonary Disease as Critical Risk Factor for Cardiovascular Disease.International journal of chronic obstructive pulmonary disease · 2020
    Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Claire WindsorFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Emily HerrettFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Liam SmeethFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Jennifer Kathleen QuintFaculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK.
London School of Hygiene & Tropical Medicine · GBRespiratory Clinical Trials · AU

Funding

Medical Research Council MR/K006584/1
6 · The paper itself

Abstract

backgroundPatients with chronic obstructive pulmonary disease (COPD) have a higher risk of stroke than the general population. Chronic inflammation associated with COPD is thought to contribute to this risk. Exacerbations of COPD are associated with a rise in inflammation, suggesting that there may be an association between exacerbation frequency and the risk of stroke. This study examined that association.

methodsUsing the UK Clinical Practice Research Datalink, COPD patients with a first stroke between January 2004 and December 2013 were identified as cases and matched on age, sex, and general practice to controls with COPD but without a stroke (6,441 cases and 19,323 controls). Frequent exacerbators (FEs) were defined as COPD patients with ≥2 exacerbations, and infrequent exacerbators (IEs) have ≤1 exacerbation in the year prior to their stroke. Conditional logistic regression was used to estimate the association between exacerbation frequency and stroke overall, and by stroke subtype (hemorrhagic, ischemic, or transient ischemic attack). Exacerbations were also categorized into 0, 1, 2, or ≥3 exacerbations in the year prior to stroke.

resultsThere was no evidence that FE had an increased odds of stroke compared to IE (OR [odds ratio] =0.95, 95% CI [confidence interval] =0.89-1.01). There was strong evidence that the risk of stroke decreased with each exacerbation of COPD experienced per year (P trend =0.003). In the subgroup analysis investigating stroke subtype, FE had 33% lower odds of hemorrhagic stroke than IE (OR =0.67, 95% CI =0.51-0.88, P=0.003). No association was found within other stroke types.

conclusionThis study found no evidence of a difference in the odds of stroke between IE and FE, suggesting that exacerbation frequency is unlikely to be the reason for increased stroke risk among COPD patients. Further research is needed to explore the association through investigation of stroke risk and the severity, duration, treatment of exacerbations, and concurrent treatment of cardiovascular risk factors.

Indexed as

Pulmonary Disease, Chronic ObstructiveAgedAged, 80 and overDatabases, FactualDelivery of Health CareDisease ProgressionFemaleHumansInflammationMaleMiddle AgedPrognosisRespiratory Function TestsRisk AssessmentRisk FactorsStrokeCOPD exacerbationsfrequent exacerbatorsinfrequent exacerbatorsstroke

Identifiers

PMID26893553
PMCPMC4745831
OpenAlexW2265924223

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.