Study shows potential risk of heart attack and stroke after COPD exacerbation

A recently published study indicated that approximately 1-2% of COPD patients following hospitalizations for an exacerbation (a shortness of breath attack severe enough to require hospitalization often triggered by a respiratory infection). For heart attacks, the risk was most pronounced within 1-5 days after an exacerbation, while the stroke risk was most pronounced 1-49 days after an exacerbation. (Donaldson GC, et al. Increased Risk of Myocardial Infarction and Stroke Following Exacerbation of COPD. Chest. 2010; 137(5):1091-1097)

The 1-2% range seems a very small number to us but the UK based researchers declared that even at these levels the results of their study are clinically significant because these risk levels are double those reported in stable COPD patients.

The study team suggested the reason for these increased risk levels for heart attack and stroke was that systemic inflammation associated with a COPD exacerbation event lingers beyond the event itself. Systemic inflammation is best described as persistent inflamed tissues in the lungs (and other parts of the body) that over long periods of time causes obstruction in the airways that make it difficult to breathe fully and makes it tougher for the body to fight off respiratory infections by depressing immune function.

Our only quibble with the study is the author’s conclusion that, “Knowledge of these risks would inform rational drug prescribing for prevention of cardiovascular disease, not only at exacerbation but also in stable COPD.”

What about smoking cessation? Pulmonary rehabilitation? Boosting antioxidant consumption (through diet and/or nutritional supplementation)? These three treatment strategies have been shown to reduce symptoms associated with airway inflammation (most notably reduced shortness of breath) and are not drug dependent. Further, smoking cessation and pulmonary rehab have been shown to reduce the number and intensity of subsequent exacerbation events among COPD patients. We think is in COPD patients’ best interests to discuss these other treatments options with their physicians in addition to exploring their recommendations for pharmaceutical support.  We have previously written a number of blog articles about the power of pulmonary rehabilitation and a range of antioxidant supplements that show promise for those who suffer from chronic shortness of breath. Check out our blog archive for more information on these treatment options.