@article {Bonnesen00200-2022, author = {Barbara Bonnesen and Pradeesh Sivapalan and Anna Kj{\ae}r Kristensen and Mats Christian H{\o}jbjerg Lassen and Kristoffer Grundtvig Skaarup and Ema Rastoder and Rikke S{\o}rensen and Josefin Ekl{\"o}f and Tor Biering-S{\o}rensen and Jens-Ulrik St{\ae}hr Jensen}, title = {Major cardiovascular events in patients with severe COPD with and without asthma: a nationwide cohort study}, volume = {8}, number = {3}, elocation-id = {00200-2022}, year = {2022}, doi = {10.1183/23120541.00200-2022}, publisher = {European Respiratory Society}, abstract = {Background Chronic low-grade inflammation as in asthma may lead to a higher risk of cardiovascular events. We evaluated whether patients with COPD and asthma have a higher risk of acute cardiovascular events than patients with COPD without asthma.Methods Nationwide multicentre retrospective cohort study of Danish outpatients with a specialist diagnosis of COPD with or without asthma. Patients with both COPD and asthma were propensity-score matched 1:2 to patients with COPD without asthma. The primary end-point was severe major adverse cardiac events (MACE), defined as mortal cardiovascular events and events requiring revascularisation or hospitalisation.Results A total of 52 386 Danish patients with COPD were included; 34.7\% had pre-existing cardiovascular disease, and 20.1\% had asthma in addition to their COPD. Patients with pre-existing cardiovascular disease were then propensity-score matched: 3690 patients with COPD and asthma versus 7236 patients with COPD without asthma, and similarly, for patients without pre-existing cardiovascular disease (6775 matched with 13 205). The risk of MACE was higher among patients with asthma and COPD versus COPD without asthma: hazard ratio (HR) 1.25 (95\% CI 1.13{\textendash}1.39, p\<0.0001) for patients with pre-existing cardiovascular disease and HR 1.22 (95\% CI 1.06{\textendash}1.41, p=0.005) for patients without pre-existing cardiovascular disease.Conclusion Among patients with COPD, asthma as a comorbid condition is associated with substantially increased risk of cardiovascular events. The signal was an increased risk of 20{\textendash}25\%. Based on our study and other smaller studies, asthma can be considered a risk factor for cardiovascular events among COPD patients.Among patients with COPD and pre-existing cardiovascular disease, asthma as a comorbid condition is associated with substantially increased risk of cardiovascular events. https://bit.ly/3uEtA3r}, URL = {https://openres.ersjournals.com/content/8/3/00200-2022}, eprint = {https://openres.ersjournals.com/content/8/3/00200-2022.full.pdf}, journal = {ERJ Open Research} }