Grant: CIHR-ICRH Travel Awards - General pool

Patients with chronic obstructive pulmonary disease (COPD), a lung disease, are at higher risk of heart disease than the general population. However, we do not know if risk factors used in standard heart risk assessment tools capture such high risk. We created a group of patients with COPD from a database in the United Kingdom (UK) that includes medical information from 1998 to 2018. We looked at 21 factors used in the QRISK3 (a heart disease assessment tool), which estimates the risk of heart disease around the time people were diagnosed with COPD. We calculated and compared the rates of heart diseases, adjusting for factors such as age and biological sex in our group of COPD patients to the rates seen in the overall UK population receiving primary care. Our results showed that a widely used CVD risk assessment tool, QRISK3, substantially underestimates 10-year CVD risk in COPD. The actual risk that was observed was 82% higher than what was initially predicted. We show that such an underestimation of CVD risk is especially pronounced in younger COPD patients. As such, current heart disease risk assessment tools must be validated and most likely updated to provide clinical utility for COPD patients. In the future, when creating tools to predict the risk of heart disease, it's important to include COPD as a separate factor in those tools.