Impact of COPD on cardiovascular risk factors and outcomes in people with established cardiovascular disease
Bibliographic record
Abstract
BACKGROUND: Little is known about the association between chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) in people with established CVD. Knowing if COPD is associated with a higher risk of cardiovascular events would guide appropriate secondary prevention. OBJECTIVE: To examine the risk of COPD on major adverse cardiac events (MACEs, acute myocardial infarction, stroke and cardiovascular death) in a complete real-world population of a large province, with known CVD. METHODS: We conducted a retrospective population cohort study using health administration, medication, laboratory, electronic medical record and other data from Ontario, Canada. All people with a history of CVD with and without physician-diagnosed COPD as of 2008 were followed until 2016 and cardiac risk factors, sociodemographic factors, comorbidities and other factors were compared. Sequential cause-specific hazard models adjusting for these factors determined the risk of MACE in people with COPD. RESULTS: Of 496 056 individuals with CVD in Ontario on 1 January 2008, 69 161 (13.9%) had COPD. MACE occurred more frequently among those with CVD (45.3 per 1000 person-years) and COPD compared with those with CVD alone (28.6 per 1000 person-years) (HR 1.24, 95% CI 1.21-1.26) after adjustment for cardiac risk factors, comorbidities, socioeconomic status and other factors. People with COPD were less likely to receive preventive CVD medications or see a cardiologist. CONCLUSION: In a large, real-world population of people with established CVD, COPD was associated with a higher rate of cardiovascular events but a lower rate of preventive therapy. Strategies are needed to improve secondary CVD prevention in the COPD population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".