ArticleThorax2024
QRISK3 underestimates the risk of cardiovascular events in patients with COPD.
Article in Thorax, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Community-based prediction models of cardiovascular events, acute exacerbations and all-cause mortality in individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis on behalf of the International Cardiovascular and Respiratory Alliance.BMJ open respiratory research · 2026Pooled it
- Methods to assess atherosclerotic cardiovascular risk in chronic respiratory diseases: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- Performance of cardiovascular disease risk prediction tools in chronic obstructive pulmonary disease.Annals of the American Thoracic Society · 2026Article
- Developing and validating the CE-MACE model to predict 1-year major adverse cardiovascular events post-COPD exacerbation using routine healthcare data.The European respiratory journal · 2026Article
- The systemic impact of acute exacerbations of COPD requiring hospitalisation: a narrative review.ERJ open research · 2026Review
- Risk prediction for individual patients and the pitfalls of selecting an optimal prediction model: do not judge a model by its c-statistic.European journal of epidemiology · 2026Article
- Nomogram based on quantitative lung CT features to identify cardiovascular disease in chronic obstructive pulmonary disease and predict prognosis.BMC medical imaging · 2026Article
- Undiagnosed Coronary Artery Disease in Patients with COPD.Journal of clinical medicine · 2026Article
- Cardiovascular Events in COPD: Complementary Role of Cardiac Risk and Coronary Artery Calcium Scores.Chest · 2026Observational
- Beyond the Lungs: Cardiovascular Risk in COPD Patients with a History of Tuberculosis-A Narrative Review.Journal of clinical medicine · 2026Review
- Beyond the Lungs: A Narrative Review of Cardiopulmonary Risk Reduction and Management Perspectives in Thai COPD Patients.International journal of chronic obstructive pulmonary disease · 2026Review
- Development and Internal Validation of a Prediction Model for Major Cardiovascular and Respiratory Events in Chronic Obstructive Pulmonary Disease: Nationwide Primary Care Electronic Medical Records Cohort Study.Pragmatic and observational research · 2026Article
- Development and Interpretable Machine Learning-Based Prediction of Cardiovascular Disease Risk in Chinese COPD Patients: An Analysis of the CHARLS Database.International journal of chronic obstructive pulmonary disease · 2026Article
- Management of COPD With Cardiovascular Risk in Asia: A Review by the Asian Pacific Society of Respirology COPD Assembly.Respirology (Carlton, Vic.) · 2025Review
- Evaluating the Prognostic Significance of Circulating Biomarkers of End Organ Damage in Hypertension.Journal of clinical medicine · 2025Review
- Standard Risk Scores Inadequately Estimate Subclinical Coronary Artery Disease in Chronic Obstructive Pulmonary Disease.American journal of respiratory and critical care medicine · 2025Article
- CT-Based radiomics nomogram of lung and mediastinal features to identify cardiovascular disease in chronic obstructive pulmonary disease: a multicenter study.BMC pulmonary medicine · 2025Article
- Inflammatory Markers Mediate the Association Between Cardiovascular Health and Chronic Inflammatory Airway Diseases: A Cross-Sectional Study on the Population Aged 50 Years and Above From NHANES 2013-2018.Mediators of inflammation · 2025Article
- Derivation and Definitions of Clinical Study Variables for Multiple Long Term Conditions in Patients with Chronic Obstructive Pulmonary Disease: Protocol for a Modified Delphi Methods and Consensus Study on Behalf of the International Cardiovascular and Respiratory Alliance.Pragmatic and observational research · 2025Article
- Obstructive Airway Disease is Associated with Increased Cardiovascular Disease Risk Independent of Phenotype: Evidence from Two Nationwide Population-Based Studies.International journal of chronic obstructive pulmonary disease · 2025Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease (CVD). The extent to which the excess CVD risk is captured by risk factors in QRISK, a widely used CVD risk scoring tool, is not well studied.
methodsWe created an incidence cohort of diagnosed COPD patients from the United Kingdom (UK) Clinical Practice Research Datalink GOLD database (January 1998-July 2018). The outcome was a composite of fatal or non-fatal CVD events. Sex-specific age-standardised incidence ratios (SIR) were compared with values for the UK primary-care population. The observed 10-year CVD risk was derived using the Kaplan-Meier estimator and was compared with predicted 10-year risk from the QRISK3 tool.
results13 208 patients (mean age 64.9 years, 45% women) were included. CVD incidence was 3.53 events per 100 person-years. The SIR of CVD was 1.71 (95% CI 1.61 to 1.75) in women and 1.62 (95%CI 1.54-1.64) in men. SIR was particularly high among patients younger than 65 years (women=2.13 (95% CI 1.94 to 2.19); men=1.86 (95% CI 1.74 to 1.90)). On average, the observed 10-year risk was 52% higher than QRISK predicted score (33.5% vs 22.1%). The difference was higher in patients younger than 65 years (observed risk 82% higher than predicted).
conclusionPeople living with COPD are at a significantly heightened risk of CVD over and beyond their predicted risk. This is particularly the case for younger people whose 10-year CVD risk can be >80% higher than predicted. Risk scoring tools must be validated and revised to provide accurate CVD predictions in patients with COPD.
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