Cargando…
Low lung function, sudden cardiac death and non-fatal coronary events in the general population
BACKGROUND: Many of those who suffer from a first acute coronary event (CE) die suddenly during the day of the event, most of them die outside hospital. Poor lung function is a strong predictor of future cardiac events; however, it is unknown whether the pattern of lung function impairment differs f...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449980/ https://www.ncbi.nlm.nih.gov/pubmed/34531228 http://dx.doi.org/10.1136/bmjresp-2021-001043 |
_version_ | 1784569527644717056 |
---|---|
author | Zaigham, Suneela Eriksson, Karl-Fredrik Wollmer, Per Engström, Gunnar |
author_facet | Zaigham, Suneela Eriksson, Karl-Fredrik Wollmer, Per Engström, Gunnar |
author_sort | Zaigham, Suneela |
collection | PubMed |
description | BACKGROUND: Many of those who suffer from a first acute coronary event (CE) die suddenly during the day of the event, most of them die outside hospital. Poor lung function is a strong predictor of future cardiac events; however, it is unknown whether the pattern of lung function impairment differs for the prediction of sudden cardiac death (SCD) versus non-fatal CEs. We examined measures of lung function in relation to future SCD and non-fatal CE in a population-based study. METHODS: Baseline spirometry was assessed in 28 584 middle-aged subjects, without previous history of CE, from the Malmö Preventive Project. The cohort was followed prospectively for incidence of SCD (death on the day of a first CE, inside or outside hospital) or non-fatal CE (survived the first day). A modified version of the Lunn McNeil’s competing risk method for Cox regression was used to run models for both SCD and non-fatal CE simultaneously. RESULTS: A 1-SD reduction in forced expiratory volume in 1 s (FEV(1)) was more strongly associated with SCD than non-fatal CE even after full adjustment (FEV(1): HR for SCD: 1.23 (1.15 to 1.31), HR for non-fatal CE 1.08 (1.04 to 1.13), p value for equal associations=0.002). Similar associations were found for forced vital capacity (FVC) but not FEV(1)/FVC. The results remained significant even in life-long never smokers (FEV(1): HR for SCD: 1.34 (1.15 to 1.55), HR for non-fatal CE: 1.11 (1.02 to 1.21), p value for equal associations=0.038). Similar associations were seen when % predicted values of lung function measures were used. CONCLUSIONS: Low FEV(1) is associated with both SCD and non-fatal CE, but consistently more strongly associated with future SCD. Measurement with spirometry in early life could aid in the risk stratification of future SCD. The results support the use of spirometry for a global assessment of cardiovascular risk. |
format | Online Article Text |
id | pubmed-8449980 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-84499802021-10-01 Low lung function, sudden cardiac death and non-fatal coronary events in the general population Zaigham, Suneela Eriksson, Karl-Fredrik Wollmer, Per Engström, Gunnar BMJ Open Respir Res Respiratory Epidemiology BACKGROUND: Many of those who suffer from a first acute coronary event (CE) die suddenly during the day of the event, most of them die outside hospital. Poor lung function is a strong predictor of future cardiac events; however, it is unknown whether the pattern of lung function impairment differs for the prediction of sudden cardiac death (SCD) versus non-fatal CEs. We examined measures of lung function in relation to future SCD and non-fatal CE in a population-based study. METHODS: Baseline spirometry was assessed in 28 584 middle-aged subjects, without previous history of CE, from the Malmö Preventive Project. The cohort was followed prospectively for incidence of SCD (death on the day of a first CE, inside or outside hospital) or non-fatal CE (survived the first day). A modified version of the Lunn McNeil’s competing risk method for Cox regression was used to run models for both SCD and non-fatal CE simultaneously. RESULTS: A 1-SD reduction in forced expiratory volume in 1 s (FEV(1)) was more strongly associated with SCD than non-fatal CE even after full adjustment (FEV(1): HR for SCD: 1.23 (1.15 to 1.31), HR for non-fatal CE 1.08 (1.04 to 1.13), p value for equal associations=0.002). Similar associations were found for forced vital capacity (FVC) but not FEV(1)/FVC. The results remained significant even in life-long never smokers (FEV(1): HR for SCD: 1.34 (1.15 to 1.55), HR for non-fatal CE: 1.11 (1.02 to 1.21), p value for equal associations=0.038). Similar associations were seen when % predicted values of lung function measures were used. CONCLUSIONS: Low FEV(1) is associated with both SCD and non-fatal CE, but consistently more strongly associated with future SCD. Measurement with spirometry in early life could aid in the risk stratification of future SCD. The results support the use of spirometry for a global assessment of cardiovascular risk. BMJ Publishing Group 2021-09-16 /pmc/articles/PMC8449980/ /pubmed/34531228 http://dx.doi.org/10.1136/bmjresp-2021-001043 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Respiratory Epidemiology Zaigham, Suneela Eriksson, Karl-Fredrik Wollmer, Per Engström, Gunnar Low lung function, sudden cardiac death and non-fatal coronary events in the general population |
title | Low lung function, sudden cardiac death and non-fatal coronary events in the general population |
title_full | Low lung function, sudden cardiac death and non-fatal coronary events in the general population |
title_fullStr | Low lung function, sudden cardiac death and non-fatal coronary events in the general population |
title_full_unstemmed | Low lung function, sudden cardiac death and non-fatal coronary events in the general population |
title_short | Low lung function, sudden cardiac death and non-fatal coronary events in the general population |
title_sort | low lung function, sudden cardiac death and non-fatal coronary events in the general population |
topic | Respiratory Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449980/ https://www.ncbi.nlm.nih.gov/pubmed/34531228 http://dx.doi.org/10.1136/bmjresp-2021-001043 |
work_keys_str_mv | AT zaighamsuneela lowlungfunctionsuddencardiacdeathandnonfatalcoronaryeventsinthegeneralpopulation AT erikssonkarlfredrik lowlungfunctionsuddencardiacdeathandnonfatalcoronaryeventsinthegeneralpopulation AT wollmerper lowlungfunctionsuddencardiacdeathandnonfatalcoronaryeventsinthegeneralpopulation AT engstromgunnar lowlungfunctionsuddencardiacdeathandnonfatalcoronaryeventsinthegeneralpopulation |