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Table 3 Hazard ratios for time to the first non-fatal severe CV event together, or individually, or all-cause death, comparing exposed periods in the 365 days following a moderate or severe exacerbation of COPD to the non-exposure period

From: Risk of cardiovascular events after an exacerbation of chronic obstructive pulmonary disease: results from the EXACOS-CV cohort study using the PHARMO Data Network in the Netherlands

Time period

No. of first CV events of any type

Person years of follow-up

Unadjusted

HR (95% CI)

Adjusted*

HR (95% CI)

Any non-fatal severe CV event

   

 Unexposed period

593

21,803

1

1

 1–7 days

54

98

25.9 (19.3–34.8)

20.7 (14.7–29.2)

 8–14 days

23

96

10.7 (6.9–16.5)

8.6 (5.4–13.7)

 15–30 days

23

204

5.2 (3.4–8.0)

4.3 (2.7–6.8)

 31–180 days

65

1376

2.2 (1.7–2.9)

1.8 (1.3–2.5)

 181–365 days

39

1069

1.7 (1.2–2.4)

1.5 (1.0–2.1)

ACS

   

 Unexposed period

132

21,838

1

1

 1–7 days

12

99

15.2 (8.4–27.6)

9.9 (5.0–19.4)

 8–14 days

6

97

8.7 (3.8–20.2)

7.7 (3.1–19.2)

 15–30 days

8

208

6.1 (3.0–12.6)

4.8 (2.1–10.6)

 31–180 days

19

1394

2.3 (1.4–3.7)

1.9 (1.1–3.2)

 181–365 days

12

1084

1.7 (1.0–3.1)

1.5 (0.8–2.8)

HF decompensation

    

 Unexposed period

122

21,831

1

1

 1–7 days

31

98

42.0 (28.1–62.9)

27.4 (17.3–43.4)

 8–14 days

13

96

19.9 (11.0–36.2)

12.9 (6.8–24.5)

 15–30 days

11

206

8.6 (4.6–16.1)

5.1 (2.7–9.9)

 31–180 days

27

1385

3.5 (2.3–5.3)

2.3 (1.4–3.6)

 181–365 days

12

1078

2.1 (1.2–3.8)

1.4 (0.8–2.6)

Cerebral ischaemia

    

 Unexposed period

126

21,854

1

1

 1–7 days

4

99

4.6 (1.7–12.6)

3.5 (1.2–10.6)

 8–14 days

1

98

1.5 (0.2–10.6)

1.1 (0.2–8.7)

 15–30 days

4

209

3.0 (1.1–8.2)

2.4 (0.8–7.2)

 31–180 days

7

1399

0.9 (0.4–1.8)

0.7 (0.3–1.7)

 181–365 days

11

1087

1.8 (1.0–3.4)

1.5 (0.7–3.0)

Arrhythmia

    

 Unexposed period

128

21.855

1

1

 1–7 days

10

99

9.7 (5.0–18.9)

9.4 (4.4–20.2)

 8–14 days

6

97

9.0 (3.9–20.6)

8.8 (3.5–22.4)

 15–30 days

5

208

3.7 (1.5–9.2)

4.0 (1.5–10.6)

 31–180 days

11

1396

1.4 (0.7–2.5)

1.4 (0.7–2.9)

 181–365 days

8

1085

1.3 (0.6–2.6)

1.3 (0.6–2.8)

All-cause death

    

 Unexposed period

346

21,878

1

1

 1–7 days

37

99

14.1 (10.0–20.0)

5.4 (3.6–7.9)

 8–14 days

18

98

10.2 (6.3–16.5)

4.3 (2.6–7.1)

 15–30 days

39

209

11.3 (8.1–15.8)

5.3 (3.7–7.6)

 31–180 days

89

1401

3.9 (3.1–5.0)

2.2 (1.7–2.9)

 181–365 days

38

1090

2.2 (1.6–3.1)

1.3 (0.9–1.9)

  1. ACS: Acute coronary syndrome; CI: Confidence interval; CV: Cardiovascular; HF: Heart failure; HR: Hazard ratio
  2. *Adjusted for baseline covariates: year of cohort entry, age, sex, socio-economic status, obesity, type 2 diabetes, disorders of lipoprotein metabolism and other lipidaemias, ischaemic heart disease, hypertensive disease, heart failure, venous thromboembolism, cerebrovascular disease, arrhythmia, asthma, chronic kidney disease or renal failure, severe mental illness and/or anxiety disorder, and time-dependent covariates: number of GP visits in the last 12 months, number of moderate or severe prior exacerbations, long-acting and short-acting inhaled COPD drug use, roflumilast and/or theophylline, cardiac drugs and metabolic drugs, and a prior “competing” CV event