Risk Factors Of Cardiovascular Events In Patients With COPD

Research background:Chronic obstructive pulmonary disease（COPD）is currently the fourth leading cause of death in the world,but it is expected to become the third leading cause of death after 2020.Patients with COPD are in chronic inflammatory state for a long time,and their chronic inflammation often leads to cardiovascular events.After the occurrence of cardiovascular events,the patients’economic pressure,quality of life and life expectancy decreased.In order to improve the awareness and vigilance of clinicians to the central vascular events of COPD patients,this study conducts clinical research on the risk of cardiovascular events of COPD patients,so as to identify the existence of central vascular events of COPD patients as early as possible,formulate individualized treatment programs for COPD patients,reduce the mortality of patients and improve the prognosis.Research purpose:To explore the risk factors and clinical characteristics of cardiovascular events in COPD;Method:1.This study is a regression clinical control study.From August 2018 to January2020,234 inpatients in the Department of respiratory and critical care medicine of the Second Affiliated Hospital of Nanchang University were selected.According to the existence of cardiovascular events,the patients were divided into two groups:group A（89 cases）with COPD and group B（145 cases）with COPD.According to different cardiovascular events,group B was divided into three groups:hypertension group（39cases）,pulmonary heart disease group（49 cases）,arrhythmia group（30 cases）and coronary heart disease group（27 cases）.2.Spss26.0 statistical software was used for data analysis.The clinical data of group A and group B were compared and analyzed.General data:age,gender,length of hospital stay;blood gas analysis:oxygen partial pressure（PO2）,arterial carbon dioxide partial pressure（PCO2）;biochemical indicators:troponin,triglyceride,cholesterol;inflammatory indicators:C-reactive protein（CRP）,white blood cell count（WBC）Count,WBC,fibrinogen,interleukin-6（IL-6）;pulmonary function:forced expiratory volume in the first second as a percentage of the expected value（FEV1%）,degree of airflow restriction.Further analysis of COPD after different cardiovascular events in the above indicators of statistical differences.Result:There were 234 COPD patients in this study.The age,gender,length of stay,PO2,pCO2,troponin,triglyceride,cholesterol,CRP,WBC,fibrinogen,IL-6,FEV1%of the patients in the two groups were compared.It was found that the age,length of stay,pCO2,CRP,WBC,fibrinogen and IL-6 in group B were significantly higher than those in group A（P<0.05）.PO2 and FEV1%in group B were lower than those in group A（P<0.05）In group A,the difference was statistically significant（P<0.05）.There was no significant difference in gender,triglyceride and cholesterol between the two groups（P>0.05）.After comparing the degree of airflow restriction between the two groups,we found that the proportion of patients with cardiovascular events increased with the aggravation of airflow restriction,the difference was statistically significant（P<0.05）.Comparison of different cardiovascular events:1.FEV1%of the patients in cor pulmonale group was lower than that in hypertension group,arrhythmia group and coronary heart disease group.The cholesterol and PCO₂ of the patients with cor pulmonale were higher than those of the patients with hypertension,arrhythmia and coronary heart disease.2.The level of troponin in coronary heart disease group was higher than that in hypertension group,cor pulmonale group and arrhythmia group.After correlation analysis,we found that age,fibrinogen,CRP,troponin were positively correlated with cardiovascular events in COPD patients,FEV1%,PO₂ were negatively correlated with cardiovascular events in COPD patients.Gender,WBC,triglyceride,cholesterol,IL-6,pCO₂ were not associated with cardiovascular events in COPD patients.After logistic regression,FEV1%,CRP and age were the risk factors of cardiovascular events in COPD patients.Conclusion:1.The risk of cardiovascular events in COPD patients increases with age.2.Systemic inflammation of COPD may promote the occurrence of cardiovascular events,especially the rise of CRP,whereas the presence of cardiovascular events may aggravate systemic inflammation of COPD.3.The decrease of pulmonary function in COPD patients may promote the occurrence of cardiovascular events,especially the decrease of FEV1%.On the contrary,the existence of cardiovascular events may accelerate the decline of pulmonary function in COPD patients.4.The increase of age,inflammatory level and airflow restriction in patients with COPD have positive significance for early identification of high-risk patients with cardiovascular events.