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Heightened long-term cardiovascular risks after exacerbation of chronic obstructive pulmonary disease
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  • Published on:
    The association of pulmonary thromboembolism and chronic obstructive pulmonary disease

    In view of the fact that the association of pulmonary embolism (PE) and chronic obstructive pulmonary disease (COPD) is one fraught with the risk of PE recurrence, and fatal outcome, respectively [1], the association of the two disorders is one that should have merited some mention in the review of heightened long term cardiovascular risk after exacerbations of COPD [2], notwithstanding the uncertainty about the true prevalence of PE in patients with COPD [3],[4] . The uncertainty about PE prevalence in COPD is, arguably, in part, attributable to the fact that some COPD patients have coexisting carcinomatosis as a risk factor for PE in its own right [3]. In a systematic review and meta-analysis published in 2009, Rizkallah et al documented a PE prevalence amounting to 19.9%(95% Confidence Interval 6.7% to 33%) among patients with acute exacerbations of COPD[4]. Anecdotal reports also document the association of right heart thrombi (one of the stigmata of pulmonary thromboembolism) and COPD [5-8].
    Over and above its association with PE, COPD also appears to be a risk factor for the occurrence of "in situ" thrombosis in the pulmonary arterial vasculature [9],[10], a development which is a long term risk factor for right heart failure.
    Arguably, in view of the prothrombotic environment generated by acute exacerbations of COPD, and the fact that atrial fibrillation might be prevalent in approximately 15% of COPD patients [2], there might b...

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    Conflict of Interest:
    None declared.