Risk Factors Associated to Cardiovascular Events after Bronchiectasis Exacerbation: A Prospective Study

Introduction: Population-based and retrospective studies suggest an increased cardiovascular risk in bronchiectasis, although there is a lack of prospective studies. Aims and Objectives: The aim of this study was to prospectively characterize the frequency and type of new cardiovascular events (CVE), and to identify clinical risk factors for CVE in patients with bronchiectasis after an exacerbation diagnosis. Methods: Observational, prospective study of patients with bronchiectasis enrolled in two tertiary-care hospitals. Only the first exacerbation per patient after enrollment was considered. Variables including demographics, comorbidities, microbiology, and severity were recorded and evaluated. CVE incidence was evaluated as main outcome. Multiple imputations with Bayesian models were performed for the statistical analysis. Results: We included 250 exacerbations. The median follow-up was 35 (22-64) months. A total of 74 (29.6%) patients had a CVE and 93 (37.2%) died during the study period. Through a Bayesian approach, the analysis showed that some characteristics were likely to be associated with an increased risk of CVE, with the following probability: age 99.9%, previous vascular disease 99%, arterial hypertension 98%, renal disease 89%, chronic obstructive pulmonary disease 99%, and diabetes mellitus 83.6%. Severe exacerbations were also likely to be associated with an increased probability risk of CVE of 91.6%. Conclusions: Severity of exacerbations and host comorbid conditions are useful for CVE risk evaluation after bronchiectasis exacerbations.