References – Understanding Cardiopulmonary Risk in COPD and Opportunities for New Treatment Modalities – EPR Issue 3 2024

  1. World Health Organisation. COPD Factsheet. Available at: Last accessed: May 2024.
  2. Donaldson GC, et al. Increased risk of myocardial infarction and stroke following exacerbation of COPD. Chest. 2010;137:1091-1097;9-2029.
  3. Whittaker H, et al. Frequency and Severity of Exacerbations of COPD Associated with Future Risk of Exacerbations and Mortality: A UK Routine Health Care Data Study. Int J Chron Obstruct Pulmon Dis. 2022;17:427-437.
  4. Rothnie KJ, et al. Natural History of Chronic Obstructive Pulmonary Disease Exacerbations in a General Practice-based Population with Chronic Obstructive Pulmonary Disease. Am J Resp Crit Care Med. 2018;198(4): pp.464-471.
  5. HO TW, et al. In-hospital and one-year mortality and their predictors in patients hospitalized for first-ever chronic obstructive pulmonary disease exacerbations: A nationwide population-based study. PLOS ONE. 2014;9 (12): e114866.
  6. De Soyza A, et al. Large trials, new knowledge: the changing face of COPD management. Eur Respir J. 2015 Jun;45(6):1692-703. doi: 10.1183/09031936.00179714. Epub 2015 Mar 18. PMID: 25792640.
  7. American Lung Association. The Heart and Lungs: The Ultimate Relationship. Available at: Last accessed: May 2024.
  8. Chen, H. et al. Association between chronic obstructive pulmonary disease and cardiovascular disease in adults aged 40 years and above data from NHANES 2013–2018. BMC Pulm Med
  9. Act on COPD. Available at:,is%20termed%20%E2%80%9Ccardiopulmonary%20risk.%E2%80%9D. Last accessed: May 2024
  10. Klaus F. Rabe et al. Cardiovascular disease and COPD: dangerous liaisons? European Respiratory Review 2018 27: 180057; DOI: 10.1183/16000617.0057-2018
  11. Hurst et al. MACE in COPD: addressing cardiopulmonary risk. The Lancet, Volume 12, Issue 5, P345-348. Mar 2024
  12. Papaporfyriou A, et al. Cardiovascular Diseases in COPD: From Diagnosis and Prevalence to Therapy. Life (Basel). 2023 May 31;13(6):1299.
  13. Don D. Sin et al. Why Are Patients With Chronic Obstructive Pulmonary Disease at Increased Risk of Cardiovascular Diseases? Circulation, Available at:,important%20risk%20factor%20for%20atherosclerosis.&text=Even%20modest%20reductions%20in%20expiratory,independent%20of%20other%20risk%20factors. Last accessed: May 2024
  14. The Parliament Magazine EU must act against ‘third biggest killer worldwide’ Available at: EU must act against ‘third biggest killer worldwide’ ( Last accessed: May 2024.
  15. Asthma + Lung UK, COPD in the UK Report. Available at: Last accessed: May 2024.
  16. Eurostat data for 2011-2018, Causes of death – standardised death rate by region of residence. Available at: Last accessed: May 2024
  17. Snell N, et al. S32 Epidemiology of chronic obstructive pulmonary disease (COPD) in the UK: findings from the British Lung Foundation’s ‘Respiratory health of the nation’ project, Thorax 2016;71:A20.
  18. Lindenauer PK, et al. Risk Trajectories of Readmission and Death in the First Year After Hospitalization for Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2018 Apr 15;197(8):1009-1017.
  19. García-Sanz MT, et al. One-year and long-term mortality in patients hospitalized for chronic obstructive pulmonary disease. J Thorac Dis. 2017; 9 (3): 636‐ doi:10.21037/jtd.2017.03.34.
  20. Mannino DM, et al. Global Initiative on Obstructive Lung Disease (GOLD) classification of lung disease and mortality: findings from the Atherosclerosis Risk in Communities (ARIC) study. Respir Med. 2006;100: pp.115-122.
  21. NHS England. Respiratory Disease. Available at:,the%20UK%20%C2%A311billion%20annually. Last accessed: May 2024
  22. Financial Times, COPD: A Public Health Priority. Available at:,both%20the%20public%20and%20policymakers. Last accessed: May 2024
  23. Salciccioli JD, et al. Respiratory disease mortality in the United Kingdom compared with EU15+ countries in 1985-2015: observational study. BMJ. 2018 Nov 28;363:k4680. doi: 10.1136/bmj.k4680. PMID: 30487157; PMCID: PMC6259045.
  24. Singh D, et al. Overcoming Therapeutic Inertia to Reduce the Risk of COPD Exacerbations: Four Action Points for Healthcare Professionals. Int J Chron Obstruct Pulmon Dis. 2021 Nov 1;16:3009-3016. doi: 10.2147/COPD.S329316. PMID: 34754186; PMCID: PMC8570921.
  25. Shrikrishna D, et al. Exacerbating the burden of cardiovascular disease: how can we address cardiopulmonary risk in individuals with chronic obstructive pulmonary disease? Eur Heart J. 2024 Jan 27;45(4):247-249. doi: 10.1093/eurheartj/ehad669. PMID: 37832033; PMCID: PMC10821359.
  26. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024. [Online]. Available at: Last accessed: May 2024 
  27. Singh, D. Et al. Implications of Cardiopulmonary Risk for the Management of COPD: A Narrative Review. Adv Ther (2024).
  28. Campion E Quinn, 100 Questions & Answers about Chronic Obstructive Pulmonary Disease (COPD).
  29. Swart KMA, et al. Risk of cardiovascular events after an exacerbation of chronic obstructive pulmonary disease: results from the EXACOS-CV cohort study using the PHARMO Data Network in the Netherlands. Respir Res. 2023 Nov 21;24(1):293. doi: 10.1186/s12931-023-02601-4.
  30. Kunisaki KM, et al. Exacerbations of Chronic Obstructive Pulmonary Disease and Cardiac Events. A Post Hoc Cohort Analysis from the SUMMIT Randomized Clinical Trial. Am J Respir Crit Care Med. 2018 Jul 1;198(1):51-57. doi: 10.1164/rccm.201711-2239OC.
  31. Hawkins NM, et al. Heightened long-term cardiovascular risks after exacerbation of chronic obstructive pulmonary disease. Heart. 2024 Apr 25;110(10):702-709. doi: 10.1136/heartjnl-2023-323487. PMID: 38182279; PMCID: PMC11103306.
  32. Daniels K, et al. Risk of Death and Cardiovascular Events Following an Exacerbation of COPD: The EXACOS-CV US Study. Int J Chron Obstruct Pulmon Dis. 2024;19:225-241
  33. O’Toole J, et al. Understanding barriers to and strategies for medication adherence in COPD: a qualitative study. BMC Pulm Med. 2022 Mar 19;22(1):98. doi: 10.1186/s12890-022-01892-5. PMID: 35305609; PMCID: PMC8934480.
  34. Stolz D., et al. Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission. The Lancet Commissions. Vol.400 Issue 10356 (Sept. 2022); pp.921-972.