Increased risk of myocardial infarction and stroke following exacerbation of COPD.

Abstract:

OBJECTIVE:Patients with COPD are at risk for cardiovascular events. This is attributed to increased systemic inflammation. The course of COPD is punctuated by exacerbations, which further increase systemic inflammation, but the risk of vascular events in the postexacerbation period has never been defined. METHODS:We analyzed data from 25,857 patients with COPD entered in The Health Improvement Network database over a 2-year period. Exacerbations were defined using a health-care use definition of prescription of oral corticosteroids > 20 mg/d and/or selected oral antibiotics. The risk of myocardial infarction (MI) and stroke in the postexacerbation period was calculated relative to the patient's baseline risk using the self-controlled case series approach. RESULTS:We identified 524 MIs in 426 patients and 633 ischemic strokes in 482 patients. The incidence rates of MI and stroke were 1.1 and 1.4 per 100 patient-years, respectively. There was a 2.27-fold (95% CI, 1.1-4.7; P = .03) increased risk of MI 1 to 5 days after exacerbation (defined by prescription of both steroids and antibiotics). This relative risk diminished progressively with time and was not significantly different from the baseline MI risk at any other postexacerbation time interval. One in 2,513 exacerbations was associated with MI within 1 to 5 days. There was a 1.26-fold (95% CI, 1.0-1.6; P = .05) increased risk of stroke 1 to 49 days after exacerbation. CONCLUSION:The results suggest that exacerbations of COPD increase the risk of MI and stroke. This may have implications for therapy in both stable and exacerbated COPD.

journal_name

Chest

journal_title

Chest

authors

Donaldson GC,Hurst JR,Smith CJ,Hubbard RB,Wedzicha JA

doi

10.1378/chest.09-2029

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

1091-7

issue

5

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(10)60235-8

journal_volume

137

pub_type

杂志文章

相关文献

CHEST文献大全
  • The role of open lung biopsy in patients with the acquired immunodeficiency syndrome.

    abstract::To assess the role of open lung biopsy in patients with the acquired immunodeficiency syndrome (AIDS), we retrospectively reviewed the cases of 42 patients with AIDS who underwent this procedure for the diagnosis of pulmonary infiltrates. Four patients had no preceding bronchoscopy because the severity of the respirat...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.91.5.659

    authors: Fitzgerald W,Bevelaqua FA,Garay SM,Aranda CP

    更新日期:1987-05-01 00:00:00

  • Simplified prediction rule for prognosis of patients with severe community-acquired pneumonia in ICUs.

    abstract:STUDY OBJECTIVES:To develop a simplified prognostic prediction rule for patients admitted to ICUs for severe community-acquired pneumonia (CAP). SETTING:Six ICUs in the north of France. PATIENTS:Five hundred five patients admitted to ICUs over a 9-year period (from 1987 to 1995) for severe CAP. INTERVENTIONS:Retrosp...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.116.1.157

    authors: Leroy O,Devos P,Guery B,Georges H,Vandenbussche C,Coffinier C,Thévenin D,Beaucaire G

    更新日期:1999-07-01 00:00:00

  • Pulmonary Artery Invasion Caused by Mycobacterium tuberculosis.

    abstract::Extrapulmonary tuberculosis refers to Mycobacterium tuberculosis involving organs other than the lungs (eg, pleura, lymph nodes, genitourinary tract, abdomen, skin, joints and bones, or meninges). In non-HIV-endemic areas, where reactivation is the predominant mechanism of tuberculosis, pleural involvement occurs in 4...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2016.02.655

    authors: Gleason JB,Tashtoush B,Mehta J,Savage E,Martinez F,Mehta AC

    更新日期:2016-10-01 00:00:00

  • Childhood asthma and the indoor environment in a subtropical area.

    abstract:STUDY OBJECTIVES:The objective of this study is to examine the relationship between indoor environmental factors and childhood asthma in a subtropical area. DESIGN:A case-control study was performed using participants of a prevalence survey that included 165 schoolchildren with asthma and 165 age- and gender-matched c...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.114.2.393

    authors: Yang CY,Lin MC,Hwang KC

    更新日期:1998-08-01 00:00:00

  • Massive hemoptysis from a pulmonary artery aneurysm associated with an emphysematous bulla.

    abstract::A 66-year-old man with a history of COPD and Aspergillus fumigatus infection developed massive hemoptysis. Pulmonary artery angiography revealed an aneurysm which was successfully treated with coil embolization. This is the first known report of a pulmonary artery aneurysm causing massive hemoptysis in a patient with ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.113.4.1130

    authors: Bowler RP,Durham J,Schwarz MI

    更新日期:1998-04-01 00:00:00

  • Overdiagnosis of COPD in Subjects With Unobstructed Spirometry: A BOLD Analysis.

    abstract:BACKGROUND:There are several reports on underdiagnosis of COPD, while little is known about COPD overdiagnosis and overtreatment. We describe the overdiagnosis and the prevalence of spirometrically defined false positive COPD, as well as their relationship with overtreatment across 23 population samples in 20 countries...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2019.01.015

    authors: Sator L,Horner A,Studnicka M,Lamprecht B,Kaiser B,McBurnie MA,Buist AS,Gnatiuc L,Mannino DM,Janson C,Bateman ED,Burney P,BOLD Collaborative Research Group.

    更新日期:2019-08-01 00:00:00

  • Pulmonary hypertension in chronic obstructive pulmonary disease. Multivariate analysis.

    abstract::The severity of pulmonary hypertension was evaluated by right cardiac catheterization in 89 patients with stable chronic obstructive pulmonary disease, both at rest and during maximum treadmill exercise. Thirty-one patients were found to have pulmonary hypertension at rest, defined as a mean pulmonary arterial pressur...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.90.2.185

    authors: Keller CA,Shepard JW Jr,Chun DS,Vasquez P,Dolan GF

    更新日期:1986-08-01 00:00:00

  • Repetitive ventricular fibrillation preceded by both ST segment depression and elevation during acute myocardial ischemia.

    abstract::A patient had repetitive ventricular fibrillation preceded by alternating ST segment depression and elevation. The ECG changes were confined to the precordial leads only, reflecting subendocardial and transmural ischemia, respectively. It is speculated that the patient exhibited consecutive episodes of subtotal and to...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.93.6.1296

    authors: Rechavia E,Sagie A,Kusniec J,Mager A,Sclarovsky S

    更新日期:1988-06-01 00:00:00

  • Incidence and impact of organ dysfunctions associated with sepsis.

    abstract:OBJECTIVE:To study the incidence and severity of organ dysfunction associated with sepsis. DESIGN:Comprehensive review of prospectively collected data from intensive care patients hospitalized between 1997 and 2001. SETTING:Thirty-five ICUs in nonuniversity and university hospitals located in the Paris area. PATIENT...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.127.3.942

    authors: Guidet B,Aegerter P,Gauzit R,Meshaka P,Dreyfuss D,CUB-Réa Study Group.

    更新日期:2005-03-01 00:00:00

  • The short-term effects of smoke exposure on the pulmonary function of firefighters.

    abstract::The short-term effects of smoke inhalation have been little studied. This study evaluated whether firefighters experience a significant change in spirometric values following exposure to smoke from a fire. Sixty firefighters from the city of Pittsburgh completed a questionnaire (Medical Research Council) and underwent...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.4.806

    authors: Large AA,Owens GR,Hoffman LA

    更新日期:1990-04-01 00:00:00

  • Control of high density bacterial contamination of the fiberoptic bronchoscope.

    abstract::In a double-blind study the fiberoptic bronchoscope was contaminated with five pathogenic organisms, each at a concentration of 10(9) organisms per milliliter. The shaft and inner channel of the bronchoscope were cleansed with five antiseptic regimens. Each regimen included equal 120-ml aliquots of one, two, or three ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.72.1.10

    authors: Donaldson JC,Stoop DR,Williams SA

    更新日期:1977-07-01 00:00:00

  • Histologic assessment of tumor-associated CD45(+) cell numbers is an independent predictor of prognosis in small cell lung cancer.

    abstract:BACKGROUND:Small cell lung carcinoma (SCLC) continues to have a poor prognosis, with a 2-year survival of < 20%. Studies have suggested that SCLC may affect the immune system to allow it to evade immunologic responses. We hypothesized that any such effect would be characterized by a decrease in the lymphoid cells assoc...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.12-0681

    authors: Wang W,Hodkinson P,McLaren F,Mackean MJ,Williams L,Howie SEM,Wallace WAH,Sethi T

    更新日期:2013-01-01 00:00:00

  • Comparing two heat and moisture exchangers with one vaporizing humidifier in patients with minute ventilation greater than 10 L/min.

    abstract:STUDY OBJECTIVE:To evaluate in patients submitted to minute ventilation > 10 L/min the ability to preserve patients' heat and humidity of two heat and moisture exchangers (HMEs) and one vaporizing humidifier (VH). DESIGN:Prospective, randomized, comparative, non-blinded study. SETTING:Intensive care unit of a univers...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.107.5.1411

    authors: Martin C,Thomachot L,Quinio B,Viviand X,Albanese J

    更新日期:1995-05-01 00:00:00

  • Obstructing tracheal pulmonary Langerhans cell histiocytosis.

    abstract::Pulmonary Langerhans cell histiocytosis, also known as eosinophilic granuloma, is an uncommon interstitial lung disease. A solitary nodule, usually parenchymal, may rarely be the only manifestation of the disease. We describe a case of Langerhans cell histiocytosis presenting as an obstructing tracheal lesion in a 55-...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.2.1057

    authors: Fridlender ZG,Glazer M,Amir G,Berkman N

    更新日期:2005-08-01 00:00:00

  • Clinical correlation of asbestos bodies in BAL fluid.

    abstract:BACKGROUND:Asbestos bodies (AB) in BAL cells are specific markers of asbestos exposure. METHODS:We retrospectively reviewed BAL cytocentrifuge slides of 30 utility workers with a history of asbestos exposure and 30 normal volunteers. BAL cytocentrifuge slides were blinded and scanned under 40 x light microscope. RESU...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.126.3.966

    authors: Vathesatogkit P,Harkin TJ,Addrizzo-Harris DJ,Bodkin M,Crane M,Rom WN

    更新日期:2004-09-01 00:00:00

  • Survival characteristics after neodymium: YAG laser photoresection in advanced stage lung cancer.

    abstract::In order to assess the long-term clinical benefits of palliative Nd:YAG laser photoresection, we studied 69 patients with obstructing exophytic tracheobronchial lesions treated with this modality between Oct 25, 1984 and May 8, 1989. In 55 patients, there was greater than 75 percent restoration of the luminal caliber ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.3.581

    authors: Ross DJ,Mohsenifar Z,Koerner SK

    更新日期:1990-09-01 00:00:00

  • Worsening of vasovagal syncope after beta-blocker therapy.

    abstract::Head-up tilt test was done in a 27-year-old man with recurrent syncope of unexplained cause. Severe sinus bradycardia and hypotension accompanied by light-headedness, cold sweating, and nausea occurred at 80 degrees head-up position during 4 micrograms/min isoproterenol infusion. Oral propranolol, 160 mg/d, in four di...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.106.3.963

    authors: Wang CC,Yeh SJ,Wen MS,Lin FC,Wu D

    更新日期:1994-09-01 00:00:00

  • Changing the work environment in ICUs to achieve patient-focused care: the time has come.

    abstract::The American Association of Critical-Care Nurses (AACN) Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians (ACCP) Patient-Focused Care Project are complementary initiatives that provide a road map for creating practice environments where interdisciplinary, ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.130.5.1571

    authors: McCauley K,Irwin RS

    更新日期:2006-11-01 00:00:00

  • Diagnosis of Pneumocystis carinii infection in HIV-seropositive patients by identification of P carinii in pleural fluid.

    abstract::Pneumocystis carinii pneumonia (PCP) is the most common pulmonary complication of AIDS and is typically diagnosed by the identification of P carinii organisms in sputum, bronchoalveolar lavage fluid, or tissue obtained with transbronchial biopsy. We describe two HIV-seropositive patients with pleural effusions in whom...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.6.1890

    authors: Schaumberg TH,Schnapp LM,Taylor KG,Golden JA

    更新日期:1993-06-01 00:00:00

  • Long-term intermittent exposure to high ambient CO2 causes respiratory disturbances during sleep in submariners.

    abstract:BACKGROUND:During most of the cruise, submarines are detached from their environment. Therefore, O(2) levels are relatively low (19 kPa, 144 mm Hg) and CO(2) levels are high (1 kPa, 7.6 mm Hg). There are, however, periods during ventilation of the submarine in which CO(2) levels drop and O(2) levels increase. The objec...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.124.5.1716

    authors: Margel D,White DP,Pillar G

    更新日期:2003-11-01 00:00:00

  • Dynamic expiratory tracheal collapse in COPD: correlation with clinical and physiologic parameters.

    abstract:BACKGROUND:COPD has been described as a risk factor for excessive expiratory tracheal collapse, but its prevalence and clinical correlates have not been fully determined. The purpose of this study is to prospectively determine the prevalence of excessive expiratory tracheal collapse among patients with COPD and to test...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.12-0299

    authors: Boiselle PM,Michaud G,Roberts DH,Loring SH,Womble HM,Millett ME,O'Donnell CR

    更新日期:2012-12-01 00:00:00

  • Is an abbreviated bronchial challenge with histamine valid?

    abstract::Investigators have validated an abbreviated protocol for testing nonspecific bronchial reactivity with methacholine. We performed a similar validation study with histamine, another bronchoprovocative agent known to induce airflow obstruction. Histamine is pharmacologically distinct from methacholine and, under some ci...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.101.1.141

    authors: Schmidt LE,Thorne PS,Watt JL,Schwartz DA

    更新日期:1992-01-01 00:00:00

  • Anatomy and neurophysiology of cough: CHEST Guideline and Expert Panel report.

    abstract::Bronchopulmonary C-fibers and a subset of mechanically sensitive, acid-sensitive myelinated sensory nerves play essential roles in regulating cough. These vagal sensory nerves terminate primarily in the larynx, trachea, carina, and large intrapulmonary bronchi. Other bronchopulmonary sensory nerves, sensory nerves inn...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.14-1481

    authors: Canning BJ,Chang AB,Bolser DC,Smith JA,Mazzone SB,McGarvey L,CHEST Expert Cough Panel.

    更新日期:2014-12-01 00:00:00

  • Paradoxic improvement in regional wall motion during high-dose dobutamine stress echocardiography. A marker for hibernating myocardium?

    abstract::Dobutamine stress echocardiography detects myocardial ischemia by inducing regional left ventricular systolic dysfunction. Augmentation of wall motion in hypokinetic segments has also been noted with low-dose dobutamine, suggesting myocardial viability. We report a case of regional ventricular improvement during high-...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.1.291

    authors: Krauss D,Feldman T,Marcus RH,Resnekov L,Lang RM

    更新日期:1994-07-01 00:00:00

  • Ventricular tachyarrhythmias following surgery for myocardial revascularization. A follow-up study.

    abstract::Of 1,599 patients who underwent surgery for direct myocardial revascularization in 1973 at Cleveland Clinic Hospital, 19 patients (1.2 percent) developed primary ventricular fibrillation or ventricular tachycardia during the immediate postoperative period. Occurrence of postoperative ventricular tachyarrhythmias could...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.72.4.426

    authors: Abedin Z,Soares J,Phillips DF,Sheldon WC

    更新日期:1977-10-01 00:00:00

  • Roxithromycin reduces the degree of bronchial hyperresponsiveness in children with asthma.

    abstract::We evaluated the effects of a new semisynthetic macrolide antibiotic, roxithromycin, on the bronchial hyperresponsiveness to histamine in children with asthma. Twelve hospitalized asthmatic children, aged 11 to 15 years (mean age, 12.9 years), were enrolled in this study. They were treated with 150 mg of roxithromycin...

    journal_title:Chest

    pub_type: 临床试验,杂志文章

    doi:10.1378/chest.106.2.458

    authors: Shimizu T,Kato M,Mochizuki H,Tokuyama K,Morikawa A,Kuroume T

    更新日期:1994-08-01 00:00:00

  • Expanded clinical presentation of community-acquired methicillin-resistant Staphylococcus aureus pneumonia.

    abstract:BACKGROUND:Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has been documented to cause community-acquired pneumonias (CAP), notable for necrotizing features. The frequency of occurrence, risk factors, and optimal treatment of CA-MRSA CAP are unclear. METHODS:This was a retrospective analysis ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.09-1562

    authors: Lobo LJ,Reed KD,Wunderink RG

    更新日期:2010-07-01 00:00:00

  • Anti-inflammatory action of erythromycin. Its inhibitory effect on neutrophil NADPH oxidase activity.

    abstract::The effects of erythromycin on the NADPH oxidase activity in the neutrophils of normal subjects and patients with bronchiolitis were investigated. In the patients receiving erythromycin, NADPH oxidase activity was significantly lower in a whole-cell system than that before therapy. Erythromycin was also found to inhib...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.4.1191

    authors: Umeki S

    更新日期:1993-10-01 00:00:00

  • PEEP and "reverse mismatch". A case where less PEEP is best.

    abstract::A V/Q lung scan was obtained in a patient with LLL collapse who was receiving IPPV and PEEP. This revealed absent ventilation and hyperperfusion to the collapsed lobe. After a reduction in PEEP from 12 to 5 cm H2O, a repeat V/Q scan showed a more even distribution of pulmonary perfusion. Arterial hypoxemia improved. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.4.1034

    authors: Hawker FH,Torzillo PJ,Southee AE

    更新日期:1991-04-01 00:00:00

  • Characterization of chronic fatigue in patients with sarcoidosis in clinical remission.

    abstract:BACKGROUND:Patients with sarcoidosis frequently complain of fatigue, even when sarcoidosis has come into clinical remission. The primary aim of this study was to assess the severity of fatigue in patients with sarcoidosis in clinical remission and to characterize it according to the international criteria for chronic f...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.10-2629

    authors: Korenromp IHE,Heijnen CJ,Vogels OJM,van den Bosch JMM,Grutters JC

    更新日期:2011-08-01 00:00:00