ArticleAnnals of the American Thoracic Society2018
Myocardial Infarction and Ischemic Stroke after Exacerbations of Chronic Obstructive Pulmonary Disease.
Article in Annals of the American Thoracic Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
52 citing papers in PubMed, 3 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- Chronic Obstructive Pulmonary Disease and the Management of Cardiopulmonary Risk in the UK: A Systematic Literature Review and Modified Delphi Study.International journal of chronic obstructive pulmonary disease · 2025Pooled it
- Pooled it
- Association of COPD exacerbations and acute cardiovascular events: a systematic review and meta-analysis.Therapeutic advances in respiratory diseasePooled it
- Efficacy of Aclidinium Bromide According to Baseline Therapy: Post-Hoc Analysis of ASCENT-COPD Randomized Trial.Advances in therapy · 2021Trial
- Trial
- The Impact of Exacerbation History on the Safety and Efficacy of Aclidinium in Patients with Chronic Obstructive Pulmonary Disease and Increased Cardiovascular Risk: ASCENT-COPD Trial.International journal of chronic obstructive pulmonary diseaseTrial
- Cardiovascular and mortality risks following COVID-19-related versus non-COVID-19-related chronic obstructive pulmonary disease exacerbations.Annals of the American Thoracic Society · 2026Article
- Cardiovascular Risk During the 90-Day Vulnerable Window After COPD Exacerbations: A Narrative Review.Life (Basel, Switzerland) · 2026Review
- Relationship between quantitative CT and cardiac function in patients with severe COPD exacerbations (ECOPD).BMJ open respiratory research · 2026Article
- Long-term cardiovascular risk after severe exacerbation of COPD: a population-based cohort study.ERJ open research · 2026Article
- Structured Cardiac Assessment and Treatment Following Exacerbations of COPD (SCATECOPD): A Pilot Randomised Controlled Trial.Biomedicines · 2025Article
- The Risk of Ischemic Stroke in Patients with Chronic Obstructive Pulmonary Disease and Atrial Fibrillation.Life (Basel, Switzerland) · 2025Article
- Risk of Atherosclerotic Cardiovascular Disease After Chronic Obstructive Pulmonary Disease Hospitalization among Primary and Secondary Prevention Older Adults.Journal of the American Heart Association · 2025Article
- Digital health technologies for improving the management of people with chronic obstructive pulmonary disease.Frontiers in digital health · 2025Review
- Is 'Cardiopulmonary' the New 'Cardiometabolic'? Making a Case for Systems Change in COPD.Pulmonary therapy · 2024Article
- Article
- Risk of Atherosclerotic Cardiovascular Disease Hospitalizations after Chronic Obstructive Pulmonary Disease Hospitalization among Older Adults.Annals of the American Thoracic Society · 2024Article
- A Research Agenda to Improve Outcomes in Patients with Chronic Obstructive Pulmonary Disease and Cardiovascular Disease: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2024Article
- Low-dose azithromycin prophylaxis in patients with atrial fibrillation and chronic obstructive pulmonary disease.Internal and emergency medicine · 2024Article
- Chronic Obstructive Pulmonary Disease Exacerbations Increase the Risk of Subsequent Cardiovascular Events: A Longitudinal Analysis of the COPDGene Study.Journal of the American Heart Association · 2024Article
Corrections and comments
- Commented on by
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
rationalePrevious studies have suggested that acute exacerbations of chronic obstructive pulmonary disease (COPD) may be associated with increased risk of myocardial infarction and ischemic stroke.
objectivesWe aimed to quantify the increased risks of myocardial infarction and ischemic stroke risk associated with both moderate and severe acute exacerbation, and to investigate factors that may modify these risks.
methodsWe performed a self-controlled case series to investigate the rates of myocardial infarction and ischemic stroke after acute exacerbation compared with stable time, within individuals. The participants were 5,696 adults with COPD with a first myocardial infarction (n = 2,850) or ischemic stroke (n = 3,010) and at least one acute exacerbation from the UK Clinical Practice Research Datalink with linked Hospital Episodes Statistics data.
resultsThe risks of both myocardial infarction and ischemic stroke were increased in the 91 days after an acute exacerbation. The risks were greater after a severe exacerbation (incidence rate ratio [IRR], 2.58; 95% confidence interval [CI], 2.26-2.95 for myocardial infarction; and IRR, 1.97; 95% CI, 1.66-2.33 for ischemic stroke) than after a moderate exacerbation (IRR, 1.58; 95% CI, 1.46-1.71 for myocardial infarction; and IRR, 1.45; 95% CI, 1.33-1.57 for ischemic stroke). The relative risks of myocardial infarction and ischemic stroke associated with acute exacerbation were lower among those with more frequent exacerbations (IRR, 1.42; 95% CI, 1.24-1.62 vs. IRR, 1.69; 95% CI, 1.50-1.91 for myocardial infarction; and IRR, 1.30; 95% CI, 1.15-1.48 vs. IRR, 1.68; 95% CI, 1.50-1.89 for ischemic stroke). Higher GOLD stage was associated with a lower rate of myocardial infarction (IRR, 1.98; 95% CI, 1.61-2.05 vs. IRR, 1.69; 95% CI, 1.45-1.98) but not for ischemic stroke. Aspirin use at baseline was associated with a lower risk of ischemic stroke (IRR, 1.28; 95% CI, 1.10-1.50 vs. IRR, 1.63; 95% CI, 1.47-1.80) but not with myocardial infarction.
conclusionsAcute exacerbations of COPD are associated with an increased risk of myocardial infarction and ischemic stroke within 28 days of their onset. Several patient characteristics were identified that are associated with these events.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.