Malo de Molina Rosa, Aguado Silvia, Arellano Carlos, Valle Manuel, Ussetti Piedad
Department of Pulmonary Medicine, University Hospital Puerta de Hierro, Majadahonda, 28040 Madrid, Spain.
Department of Cardiology, University Hospital Puerta de Hierro, Majadahonda, 28040 Madrid, Spain.
Med Sci (Basel). 2018 Sep 25;6(4):83. doi: 10.3390/medsci6040083.
Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of acute cardiovascular events, and around 30% die from cardiovascular diseases. Recent data suggest an increased risk of myocardial infarction in the following days of a severe exacerbation of COPD. Disruption in the balance during the exacerbation with tachycardia, increased inflammation and systemic oxidative stress as well as some other factors may confer an increased risk of subsequent cardiovascular events. A number of investigations may be useful to an early diagnosis, including electrocardiography, imaging techniques and blood test for biomarkers. Some drugs that have changed prognosis in the cardiovascular setting such as cardioselective beta-blockers may be underused in patients with COPD despite its demonstrated benefits. This review focuses on several aspects of exacerbation of COPD and cardiovascular events including epidemiology, possible mechanism, diagnosis and treatment.
慢性阻塞性肺疾病(COPD)患者发生急性心血管事件的风险较高,约30%死于心血管疾病。近期数据表明,在COPD严重加重后的几天内心肌梗死风险增加。急性加重期间,心动过速、炎症增加、全身氧化应激以及其他一些因素导致的平衡失调,可能会增加随后发生心血管事件的风险。多项检查对于早期诊断可能有用,包括心电图、成像技术以及生物标志物血液检测。一些在心血管疾病治疗中已改变预后的药物,如心脏选择性β受体阻滞剂,尽管已证明其益处,但在COPD患者中可能未得到充分使用。本综述重点关注COPD急性加重和心血管事件的几个方面,包括流行病学、可能机制、诊断和治疗。