{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:57:02Z","timestamp":1793415422777,"version":"4.5.0"},"reference-count":33,"publisher":"European Respiratory Society (ERS)","issue":"2","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2024,9,24]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>COPD has high mortality, compounded by comorbid cardiovascular disease. We investigated two ECG markers, Cardiac Infarction Injury Score (CIIS) and P pulmonale, as prognostic tools for adverse cardiopulmonary events in COPD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a<jats:italic>p<\/jats:italic><jats:italic>ost hoc<\/jats:italic>analysis of the IMPACT trial. Outcomes included odds (odds ratio, 95% confidence intervals) of adverse cardiopulmonary events stratified by CIIS threshold (&lt;20<jats:italic>versus<\/jats:italic>\u226520) and P pulmonale (baseline). Events included all-cause death, hospitalisation or death, cardiovascular adverse event of special interest, severe COPD exacerbations, and moderate\/severe COPD exacerbations. We also assessed the effects of fluticasone furoate\/umeclidinium\/vilanterol<jats:italic>versus<\/jats:italic>fluticasone furoate\/vilanterol or umeclidinium\/vilanterol based on CIIS and P pulmonale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 9448 patients. Patients with CIIS \u226520 (<jats:italic>versus<\/jats:italic>CIIS &lt;20) had greater odds of all-cause death (OR 1.73, 95% CI 1.27\u20132.37, p&lt;0.001), hospitalisation or death (OR 1.33, 95% CI 1.17\u20131.50, p&lt;0.001), cardiovascular adverse event of special interest (OR 1.27, 95% CI 1.08\u20131.48, p&lt;0.005), severe COPD exacerbations (OR 1.41, 95% CI 1.21\u20131.64, p&lt;0.001) and moderate\/severe COPD exacerbations (OR 1.25, 95% CI 1.13\u20131.40, p&lt;0.001). Patients with P pulmonale (<jats:italic>versus<\/jats:italic>without) had greater odds of all-cause death (OR 2.25, 95% CI 1.54\u20133.29, p&lt;0.001), hospitalisation or death (OR 1.51, 95% CI 1.28\u20131.79, p&lt;0.001), severe COPD exacerbations (OR 2.00, 95% CI 1.65\u20132.41, p&lt;0.001) and moderate\/severe COPD exacerbations (OR 1.25, 95% CI 1.08\u20131.46, p&lt;0.001). A combined model demonstrated that patients with CIIS \u226520 and P pulmonale had increased risk of all-cause death (OR 3.38, 95% CI 1.23\u20139.30, p=0.019), hospitalisation or death (OR 1.61, 95% CI 1.14\u20132.22, p=0.004) and rate of severe COPD exacerbations (OR 1.89, 95% CI 1.22\u20132.91, p=0.004) and moderate\/severe COPD exacerbations (OR 1.25, 95% CI 1.00\u20131.56, p=0.046). The risk of all-cause death and cardiovascular adverse events of special interest was reduced with fluticasone furoate\/umeclidinium\/vilanterol<jats:italic>versus<\/jats:italic>umeclidinium\/vilanterol in patients with CIIS \u226520, but not CIIS &lt;20.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings suggest the potential clinical relevance of CIIS and P pulmonale as risk indicators for adverse cardiopulmonary events in COPD.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.00171-2024","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T10:15:20Z","timestamp":1730110520000},"page":"2400171","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["ECG-based risk factors for adverse cardiopulmonary events and treatment outcomes in COPD"],"prefix":"10.1183","volume":"65","author":[{"given":"R. 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