TY - JOUR
T1 - Cardiovascular Events During and After Bronchiectasis Exacerbations and Long-term Mortality
AU - Méndez, Raúl
AU - Feced, Laura
AU - Alcaraz-Serrano, Victoria
AU - González-Jiménez, Paula
AU - Bouzas, Leyre
AU - Alonso, Ricardo
AU - Martínez-Dolz, Luis
AU - Hervás, David
AU - Fernández-Barat, Laia
AU - Torres, Antoni
AU - Menéndez, Rosario
N1 - Funding Information:
FUNDING/SUPPORT: This study was supported by Sociedad Española de Neumología y Cirugía Torácica (SEPAR [ 793/2018 ]) and Sociedad Valenciana de Neumología (SVN [ 2018 ]). Raúl Méndez is the recipient of a Río Hortega grant supported by the Instituto de Salud Carlos III (ISCIII [ CM19/00182 ]). Paula González-Jiménez is the recipient of a Post-resident research grant supported by the Health Research Institute La Fe .
Publisher Copyright:
© 2021 American College of Chest Physicians
PY - 2022/3
Y1 - 2022/3
N2 - Background: Population-based and retrospective studies have shown that risk for cardiovascular events such as arrythmias, ischemic episodes, or heart failure, increase during and after bronchiectasis exacerbations. Research Question: What are the risk factors for cardiovascular events (CVE) during and after bronchiectasis exacerbations and their impact on mortality? Study Design and Methods: This was a post hoc retrospective analysis of a prospective observational study of 250 patients with bronchiectasis at two tertiary care hospitals. Only the first exacerbation was considered for each patient, collecting demographic, comorbidity, and severity data. The main outcomes were the appearance of CVE and mortality. Risk factors for CVE were analyzed using a semi-competing risks model. Results: During a median follow-up of 35 months, 74 (29.6%) patients had a CVE and 93 (37.2%) died. Semi-competing risk analysis indicated that age, arterial hypertension, COPD, and potentially severe exacerbations significantly increased the risk for developing CVE. Compared with patients without CVE, those with CVE had higher mortality. Interpretation: Demographic factors and comorbidities are risk factors for the development of CVE after an acute exacerbation of bronchiectasis. The appearance of CVE worsens long-term prognosis.
AB - Background: Population-based and retrospective studies have shown that risk for cardiovascular events such as arrythmias, ischemic episodes, or heart failure, increase during and after bronchiectasis exacerbations. Research Question: What are the risk factors for cardiovascular events (CVE) during and after bronchiectasis exacerbations and their impact on mortality? Study Design and Methods: This was a post hoc retrospective analysis of a prospective observational study of 250 patients with bronchiectasis at two tertiary care hospitals. Only the first exacerbation was considered for each patient, collecting demographic, comorbidity, and severity data. The main outcomes were the appearance of CVE and mortality. Risk factors for CVE were analyzed using a semi-competing risks model. Results: During a median follow-up of 35 months, 74 (29.6%) patients had a CVE and 93 (37.2%) died. Semi-competing risk analysis indicated that age, arterial hypertension, COPD, and potentially severe exacerbations significantly increased the risk for developing CVE. Compared with patients without CVE, those with CVE had higher mortality. Interpretation: Demographic factors and comorbidities are risk factors for the development of CVE after an acute exacerbation of bronchiectasis. The appearance of CVE worsens long-term prognosis.
KW - bronchiectasis
KW - cardiovascular
KW - exacerbations
KW - mortality
KW - proadrenomedullin
UR - http://www.scopus.com/inward/record.url?scp=85124284106&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2021.10.013
DO - 10.1016/j.chest.2021.10.013
M3 - Article
C2 - 34656526
AN - SCOPUS:85124284106
SN - 0012-3692
VL - 161
SP - 629
EP - 636
JO - Chest
JF - Chest
IS - 3
ER -