Bronchiectasis Severity Is an Independent Risk Factor for Vascular Disease in a Bronchiectasis Cohort

Chest. 2017 Feb;151(2):383-388. doi: 10.1016/j.chest.2016.09.022. Epub 2016 Oct 6.

Abstract

Background: Interest in the association of vascular disease with COPD and pneumonia has increased, but there is a lack of research in this area with patients with bronchiectasis.

Methods: A retrospective study of 400 patients attending a specialist bronchiectasis clinic in NHS Lothian (Edinburgh, UK) between May 2013 and September 2014 was conducted. The study assessed the prevalence of vascular disease (ischemic heart disease, cerebrovascular disease, peripheral vascular disease, and atrial fibrillation). Using multivariable models, independent risk factors were identified for vascular disease that developed following the diagnosis of bronchiectasis.

Results: The study included 400 patients. There was preexisting vascular disease (ie, before the diagnosis of bronchiectasis) in 44 patients (11%), and vascular disease occurred after the diagnosis of bronchiectasis after a mean of 9.4 years (95% CI, 6.0-12.8 years) in 45 patients (11%). Independent factors associated with all-cause vascular disease after the diagnosis of bronchiectasis included male sex, hypertension, receiving long-term statin therapy, and having moderate-severity bronchiectasis or worse.

Conclusions: In conclusion, bronchiectasis severity is independently associated with the development of vascular disease after the diagnosis of bronchiectasis. Future studies addressing the impact of primary and secondary prevention are warranted.

Keywords: bronchiectasis; severity; vascular disease.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adrenergic beta-2 Receptor Agonists / therapeutic use
  • Aged
  • Atrial Fibrillation / epidemiology
  • Bronchiectasis / drug therapy
  • Bronchiectasis / epidemiology*
  • Bronchiectasis / physiopathology
  • Cardiovascular Diseases / epidemiology*
  • Cerebrovascular Disorders / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Muscarinic Antagonists / therapeutic use
  • Myocardial Ischemia / epidemiology
  • Peripheral Vascular Diseases / epidemiology
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • United Kingdom / epidemiology

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-2 Receptor Agonists
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Muscarinic Antagonists