Cardiopulmonary Event Prevalence Before First Recorded COPD Diagnosis: A Retrospective Cohort Study Using the Clinical Practice Research Datalink.
13 affiliations
- 1King's Centre for Lung Health, Peter Gorer Department of Immunobiology, King's College London, London, UK.
- 2Data Analytics, Human Data Sciences, Cardiff, UK.
- 3Evidence Statistics, BioPharmaceuticals Medical, AstraZeneca, Wilmington, DE, USA.
- 4Respiratory Evidence Strategy, Biopharmaceuticals Medical, AstraZeneca, Wilmington, DE, USA.
- 5Global Medical Respiratory, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK.
- 6Respiratory Evidence Strategy, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK.
- 7Department of Medicine, Pulmonary and Critical Care Medicine, Philipps-University of Marburg, German Center for Lung Research (DZL), Marburg, Germany.
- 8Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK.
- 9Medicines Evaluation Unit, an IQVIA Business, Manchester, UK.
- 10Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.
- 11Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
- 12Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
- 13Respiratory Evidence Strategy, Biopharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
Abstract
Post-COPD diagnosis, individuals have an increased risk of cardiopulmonary events, but little is known about the risk pre-diagnosis. This study extends previous evidence by investigating the prevalence of cardiopulmonary events before the first recorded COPD diagnosis, including within a standardised 3-year pre-diagnosis window, and compared cardiopulmonary risk with that of matched controls without COPD. This retrospective, cohort study included patients with a diagnosis of COPD in the Clinical Practice Research Datalink. The overall cohort included patients aged ≥35 years with a COPD diagnosis prior to December 31, 2019, from which an incident COPD cohort was identified with first recorded diagnosis between January 1, 2018-December 31, 2019 (index date). Cardiopulmonary events of interest were quantified within 3 years pre-index among those with ≥3 years of pre-index data and during the full look-back period. Matched non-COPD patients served as controls (1:2 ratio). Of 426,854 patients with COPD, 77,428 were incident and matched 1:2 to patients without COPD. Patients in the incident cohort (mean age 67.4 [SD 13.6] years, 52% male, 94% White) had a higher prevalence of pre-diagnosis cardiopulmonary events than controls (76.2% versus 45.6%; odds ratio (OR) 3.8, [95% CI: 3.8-3.9]). This association was consistent, with greater relative odds observed among those with ≥3 years pre-index data (n=70,062): 56.6% had a cardiopulmonary event vs 20.9% (OR 4.9, 95% CI: 4.8-5.0) within 3 years pre-index, including severe cardiovascular events in 16,679 (23.8%) and respiratory events in 32,293 (46.1%) patients. Most common severe cardiovascular events were atrial fibrillation (58.1%), heart failure (46.1%) and myocardial infarction (15.1%). Before diagnosis, patients with incident COPD also had substantially greater HCRU, including 4.3-fold higher inpatient costs than matched controls. Cardiopulmonary events are frequent before COPD diagnosis, and signal elevated cardiopulmonary risk. Understanding the occurrence of antecedent cardiopulmonary events in COPD may enable earlier diagnosis and treatment.
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BibTeX
@article{russell2026cardiopulmonary,
title = {{Cardiopulmonary Event Prevalence Before First Recorded COPD Diagnosis: A Retrospective Cohort Study Using the Clinical Practice Research Datalink.}},
author = {Richard E K Russell and Vishnav Pradeep and Jonathan A Patrick and Christopher Llewellyn Morgan and Hungta Chen and Michael Pollack and Stephanie Dods and Hana Müllerová and Claus Franz Vogelmeier and Dave Singh and Chris P Gale and Della Varghese},
journal = {International journal of chronic obstructive pulmonary disease},
year = {2026},
month = nov,
doi = {10.2147/copd.s626824},
url = {https://europepmc.org/article/MED/42997333},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Cardiopulmonary Event Prevalence Before First Recorded COPD Diagnosis: A Retrospective Cohort Study Using the Clinical Practice Research Datalink.
AU - Richard E K Russell
AU - Vishnav Pradeep
AU - Jonathan A Patrick
AU - Christopher Llewellyn Morgan
AU - Hungta Chen
AU - Michael Pollack
AU - Stephanie Dods
AU - Hana Müllerová
AU - Claus Franz Vogelmeier
AU - Dave Singh
AU - Chris P Gale
AU - Della Varghese
PY - 2026
DA - 2026/11/02
JO - International journal of chronic obstructive pulmonary disease
DO - 10.2147/copd.s626824
UR - https://europepmc.org/article/MED/42997333
AB - Post-COPD diagnosis, individuals have an increased risk of cardiopulmonary events, but little is known about the risk pre-diagnosis. This study extends previous evidence by investigating the prevalence of cardiopulmonary events before the first recorded COPD diagnosis, including within a standardised 3-year pre-diagnosis window, and compared cardiopulmonary risk with that of matched controls without COPD. This retrospective, cohort study included patients with a diagnosis of COPD in the Clinical Practice Research Datalink. The overall cohort included patients aged ≥35 years with a COPD diagnosis prior to December 31, 2019, from which an incident COPD cohort was identified with first recorded diagnosis between January 1, 2018-December 31, 2019 (index date). Cardiopulmonary events of interest were quantified within 3 years pre-index among those with ≥3 years of pre-index data and during the full look-back period. Matched non-COPD patients served as controls (1:2 ratio). Of 426,854 patients with COPD, 77,428 were incident and matched 1:2 to patients without COPD. Patients in the incident cohort (mean age 67.4 [SD 13.6] years, 52% male, 94% White) had a higher prevalence of pre-diagnosis cardiopulmonary events than controls (76.2% versus 45.6%; odds ratio (OR) 3.8, [95% CI: 3.8-3.9]). This association was consistent, with greater relative odds observed among those with ≥3 years pre-index data (n=70,062): 56.6% had a cardiopulmonary event vs 20.9% (OR 4.9, 95% CI: 4.8-5.0) within 3 years pre-index, including severe cardiovascular events in 16,679 (23.8%) and respiratory events in 32,293 (46.1%) patients. Most common severe cardiovascular events were atrial fibrillation (58.1%), heart failure (46.1%) and myocardial infarction (15.1%). Before diagnosis, patients with incident COPD also had substantially greater HCRU, including 4.3-fold higher inpatient costs than matched controls. Cardiopulmonary events are frequent before COPD diagnosis, and signal elevated cardiopulmonary risk. Understanding the occurrence of antecedent cardiopulmonary events in COPD may enable earlier diagnosis and treatment.
SN - 1176-9106
SN - 1178-2005
ER -