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Table 4 Hazard ratios for time to the composite outcome (non-fatal severe CV event or all-cause death), comparing exposed periods in the 365 days following a first, second, and third 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)

After the onset of the first exacerbation (moderate or severe)

 1–7 days

33

43

20.0 (13.7–29.4)

15.2 (10.3–22.4)

 8–14 days

20

42

12.1 (7.5–19.5)

9.3 (5.8–15.1)

 15–30 days

16

91

4.9 (3.0–8.2)

3.9 (2.3–6.4)

 31–180 days

49

704

2.0 (1.5–2.7)

1.6 (1.2–2.2)

 181–365 days

38

640

1.8 (1.3–2.5)

1.5 (1.1–2.1)

After the onset of the second exacerbation (moderate or severe)

 1–7 days

21

20

30.9 (20.0–47.7)

22.3 (14.3–34.6)

 8–14 days

6

20

8.9 (4.0–20.0)

6.5 (2.9–14.6)

 15–30 days

9

43

6.2 (3.2–12.0)

4.6 (2.4–8.9)

 31–180 days

31

289

3.3 (2.3–4.7)

2.6 (1.8–3.7)

 181–365 days

12

226

1.6 (0.9–2.9)

1.3 (0.7–2.3)

After the onset of the third exacerbation (moderate or severe)

 1–7 days

10

11

28.2 (15.1–52.7)

20.2 (10.7–38.0)

 8–14 days

3

11

8.5 (2.7–26.4)

5.8 (1.9–18.0)

 15–30 days

7

23

9.3 (4.4–19.6)

6.6 (3.1–13.9)

 31–180 days

15

148

3.1 (1.9–5.2)

2.3 (1.4–3.9)

 181–365 days

7

96

2.3 (1.1–4.8)

1.6 (0.8–3.5)

  1. CI: Confidence interval; CV: Cardiovascular; 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 prior moderate or severe exacerbations, long-acting and short-acting inhaled COPD drug use, roflumilast and/or theophylline, cardiac drugs and metabolic drugs