Major cardiovascular events associated to exacerbations of chronic obstructive pulmonary disease and related health resource use: a retrospective observational study using italian administrative data Article Swipe
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· 2025
· Open Access
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· DOI: https://doi.org/10.1093/eurjpc/zwaf236.446
Background Patients with chronic obstructive pulmonary disease (COPD) in Italy have a high risk of experiencing a major cardiovascular event (MACE) following an exacerbation, compared to those without prior exacerbation. After a moderate or severe exacerbation there is an immediate increase in the risk of MACEs, mainly heart failure, which gradually decreased over time. Purpose This retrospective observational study aimed to describe the COPD patient population experiencing a MACE after an exacerbation and the burden of hospitalizations. Methods Using Italian administrative health data, COPD patients aged ≥45 years (accrual period: 01/01/2015-12/31/2018) experiencing a moderate/severe exacerbation were analysed to assess the occurrence of fatal/non-fatal MACEs (crude incidence rate (IR) per 100 person-year (PY) [95%CI]). Also, hospitalizations within one year before and after the MACE, in-hospital procedures and costs were described. Results Among 216,864 patients with COPD, 41,859 (21.2%) and 4,355 (2.0%) experienced a non-fatal and fatal MACE, respectively, during the entire study period. Among 10,269 patients experiencing MACEs in the year post-exacerbation, the IR was 15.8 per 100 PY [15.5–16.1]. Specifically, within 7 days from exposure, the IR was 252.1 per 100 PY [245.3-258.9] and decreased over time to 5.6 [5.3-5.9] at 181-365 days. Patients with MACEs in the year post-exacerbation were older than event-free patients (n=170,650) (median age 80 (73; 85) vs 73 (64; 81) years) and had experienced more frequently at least one past exacerbation (31.4% vs 13.3%). Within one year before and after the MACE post-exacerbation, 1,595 (15.5%) and 2,185 (21.3%) patients, respectively, had additional CV-related hospitalizations (on average, 1.3 and 1.5 per patient, respectively). As regards hospitalizations, the annual mean cost per hospitalized patient was € 5,795 and € 7,460 before and after the MACE, respectively. Within one year before and after the MACE post-exacerbation, 6,209 (60.4%) and 5,133 (50.0%) patients underwent in-hospital procedures, particularly percutaneous transluminal coronary angioplasty (PTCA) and operations on vessels (OV) (on average, 7.3 and 7.8 per patient, respectively) increased by 1.7 (95 to 229 PTCAs) and 1.4 times (120 to 288 OVs), respectively. Conclusions These results suggest that COPD patients are at high risk of MACEs after exacerbation, and frequently experience re-hospitalization and coronary and vascular procedures within one year from the MACE. It is urgent the early, continuous and multidisciplinary monitoring to prevent exacerbations, MACEs, and related high resource use.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/eurjpc/zwaf236.446
- https://academic.oup.com/eurjpc/article-pdf/32/Supplement_1/zwaf236.446/63229598/zwaf236.446.pdf
- OA Status
- bronze
- Related Works
- 10
- OpenAlex ID
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Raw OpenAlex JSON
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https://openalex.org/W4410482891Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/eurjpc/zwaf236.446Digital Object Identifier
- Title
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Major cardiovascular events associated to exacerbations of chronic obstructive pulmonary disease and related health resource use: a retrospective observational study using italian administrative dataWork title
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articleOpenAlex work type
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-05-01Full publication date if available
- Authors
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Aldo P. Maggioni, Letizia Dondi, Giulia Ronconi, Letizia Dondi, Silvia Calabria, Carlo Piccinni, Irene Dell'anno, Francesco Dentali, Paola Rogliani, Clémentine Nordon, Kirsty Rhodes, Immacolata Esposito, Alice Addesi, N MartiniList of authors in order
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https://doi.org/10.1093/eurjpc/zwaf236.446Publisher landing page
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https://academic.oup.com/eurjpc/article-pdf/32/Supplement_1/zwaf236.446/63229598/zwaf236.446.pdfDirect link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://academic.oup.com/eurjpc/article-pdf/32/Supplement_1/zwaf236.446/63229598/zwaf236.446.pdfDirect OA link when available
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Medicine, Observational study, Pulmonary disease, Retrospective cohort study, Intensive care medicine, Emergency medicine, Disease, Medical emergency, Internal medicineTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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