TY - JOUR

T1 - Association between anticoagulant therapy, exacerbations and mortality in a Danish cohort of patients with Chronic Obstructive Pulmonary Disease

AU - Kristensen, A.

AU - Sivapalan, P.

AU - Bagge, K.

AU - Biering-Sørensen, T.

AU - Sørensen, R.

AU - Eklöf, J.

AU - Jensen, J. U. S.

PY - 2022

Y1 - 2022

N2 - Objectives: Pulmonary Embolism has been frequently reported in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AE-COPD). The study aimed to determine whether COPD patients who receive anticoagulant (AC) therapy have a reduced risk of hospitalization due to AE-COPD and death. Methods: This nationwide population-based study was based on data from the Danish Register of COPD (DrCOPD), which contains complete data on COPD outpatients between 1st January 2010 and 31st December 2018. National registers were used to obtain information regarding comorbidities and vital status. Propensity-score matching and Cox proportional hazards models were used to assess AE-COPD and death after one year. Results: The study cohort consisted of 58,067 patients with COPD. Of these, 5194 patients were on AC therapy. The population was matched 1:1 based on clinical confounders and AC therapy, resulting in two groups of 5180 patients. We found no association between AC therapy and AE-COPD or all-cause mortality in the propensity-score matched population (HR 1.03, 95% CI 0.96-1.10, p = 0.37). These findings were confirmed in a competing risk analysis. In the sensitivity analysis, we performed an adjusted analysis of the complete cohort and found a slightly increased risk of AE-COPD or death in patients treated with AC therapy. This study found a low incidence of pulmonary embolisms and deep venous thrombosis in both groups. Conclusions: AC therapy was not associated with the risk of hospitalization due to AE-COPD or all-cause mortality.

AB - Objectives: Pulmonary Embolism has been frequently reported in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AE-COPD). The study aimed to determine whether COPD patients who receive anticoagulant (AC) therapy have a reduced risk of hospitalization due to AE-COPD and death. Methods: This nationwide population-based study was based on data from the Danish Register of COPD (DrCOPD), which contains complete data on COPD outpatients between 1st January 2010 and 31st December 2018. National registers were used to obtain information regarding comorbidities and vital status. Propensity-score matching and Cox proportional hazards models were used to assess AE-COPD and death after one year. Results: The study cohort consisted of 58,067 patients with COPD. Of these, 5194 patients were on AC therapy. The population was matched 1:1 based on clinical confounders and AC therapy, resulting in two groups of 5180 patients. We found no association between AC therapy and AE-COPD or all-cause mortality in the propensity-score matched population (HR 1.03, 95% CI 0.96-1.10, p = 0.37). These findings were confirmed in a competing risk analysis. In the sensitivity analysis, we performed an adjusted analysis of the complete cohort and found a slightly increased risk of AE-COPD or death in patients treated with AC therapy. This study found a low incidence of pulmonary embolisms and deep venous thrombosis in both groups. Conclusions: AC therapy was not associated with the risk of hospitalization due to AE-COPD or all-cause mortality.

KW - Chronic obstructive pulmonary disease

KW - COPD

KW - anticoagulant therapy

KW - venous tromboembolism

KW - pulmonary embolism

KW - VENOUS THROMBOEMBOLISM

KW - ATRIAL-FIBRILLATION

KW - GLOBAL BURDEN

KW - PREVALENCE

KW - EMBOLISM

KW - RISK

KW - PROGNOSIS

KW - HEALTH

U2 - 10.1177/00368504221104331

DO - 10.1177/00368504221104331

M3 - Journal article

C2 - 35673760

VL - 105

JO - Science Progress

JF - Science Progress

SN - 0036-8504

IS - 2

M1 - 00368504221104331

ER -