Identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease: a multidisciplinary consensus and modified Delphi study - Scorecard - MDSpire

Identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease: a multidisciplinary consensus and modified Delphi study

  • By

  • Chris P Gale

  • John R Hurst

  • Nathaniel M Hawkins

  • Jean Bourbeau

  • MeiLan K Han

  • Carolyn S P Lam

  • Darcy D Marciniuk

  • David Price

  • Daiana Stolz

  • Ty Gluckman

  • Shelley Zieroth

  • Ramesh Nadarajah

  • Robert P Young

  • Dave Singh

  • Fernando J Martinez

  • David D Berg

  • Mohit Bhutani

  • the Global Working Group on Cardiopulmonary Risk

  • Amr Abdin

  • Dzifa Ahadzi

  • Albert B Albay

  • Bernardino Alcázar Navarrete

  • Luís Alves

  • Sameera Ansari

  • Antonio Anzueto

  • Felix Barasa

  • David D Berg

  • Andy Bevan

  • Mohit Bhutani

  • Giuseppe Biondi-Zoccai

  • Jean Bourbeau

  • Raffaele Bugiardini

  • Daniela Calderaro

  • Arturo Cortes-Telles

  • Michael G Crooks

  • Diego F Echazarreta

  • Nabil Farag

  • Fredrico L A Fernandes

  • Frits M E Franssen

  • Suzanne Fredericks

  • Chris P Gale

  • Olga M García Morales

  • Maria C Gaviria

  • Baris Gencer

  • Gonzalo Ernesto Gianella Malca

  • Kari Hanne Gjeilo

  • Ty Gluckman

  • Martha Gulati

  • MeiLan K Han

  • Nathaniel M Hawkins

  • Jeroen M Hendriks

  • John R Hurst

  • Anh-Thu Huynh Dang

  • Majdy M Idrees

  • Tobin Joseph

  • Nadim Kanj

  • Ee Ming Khoo

  • Bruce Kirenga

  • Leonie Klompstra

  • Martha Kyriakou

  • Carolyn S P Lam

  • Bouchra Lamia

  • Le Thi Tuyet Lan

  • Dominik Linz

  • Angela H E M Maas

  • Darcy D Marciniuk

  • Fernando J Martinez

  • Angela Massouh

  • Walter Mattarucco

  • Renata G Mendes

  • Anant Mohan

  • Trine Moholdt

  • Majid Mokhtari

  • Felicia Montero-Arias

  • Claudia Münks-Lederer

  • Shigeo Muro

  • Ramesh Nadarajah

  • Kazuhiro Nakao

  • Yoko M Nakao

  • Thu Nguyen Ngoc Phuong

  • Johanna O’Callaghan

  • Demosthenes Panagiotakos

  • Alberto Papi

  • Gerardo Payro

  • Massimo Piepoli

  • Marija Polovina

  • Bogdan A Popescu

  • David Price

  • Hany I Ragy

  • Keerthenan Raveendra

  • Christopher M Reid

  • Catherine Reynolds

  • Antonio Luiz P Ribeiro

  • Richard E K Russell

  • Lavanya Saiva

  • Juliana Salas Segura

  • Julie Sanders

  • Raewyn J Scott

  • Terence Seemungal

  • Dinesh Shrikrishna

  • Sami O Simons

  • Dave Singh

  • Yuanlin Song

  • Daiana Stolz

  • Abirami Subramaniam

  • Yongchang Sun

  • Raj Thakkar

  • Frederik Trinkmann

  • Izabella Uchmanowicz

  • Viola Vaccarino

  • Lowie E G W Vanfleteren

  • Rajesh Vedanthan

  • Tonya Winders

  • Jianhua Wu

  • Robert P Young

  • Jinping Zheng

  • Min Zhou

  • Shelley Zieroth

  • March 3, 2025

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Clinical Scorecard: Assessment and Management of Cardiopulmonary Risks in Individuals with Chronic Obstructive Pulmonary Disease: Insights from a Multidisciplinary Consensus and Modified Delphi Approach

At a Glance

CategoryDetail
ConditionChronic Obstructive Pulmonary Disease (COPD) with cardiovascular comorbidities
Key MechanismsShared risk factors (smoking, air pollution, diabetes, hypertension, dyslipidaemia), systemic effects of COPD and treatments, exacerbations increasing cardiopulmonary risk
Target PopulationPatients with COPD and cardiovascular risk factors or established cardiovascular disease
Care SettingMultidisciplinary care involving pulmonology, cardiology, and primary care

Key Highlights

  • Cardiovascular disease is common and underdiagnosed in COPD, increasing risk of fatal and non-fatal cardiopulmonary events.
  • Patients with cardiovascular risk factors and respiratory symptoms should undergo spirometry to confirm COPD diagnosis.
  • Management of cardiovascular comorbidities in COPD should follow established clinical guidelines with integrated multidisciplinary care.

Guideline-Based Recommendations

Diagnosis

  • Perform spirometry in patients with cardiovascular risk factors or disease who have regular cough, expectoration, recurrent chest infections, significant smoking history, or dyspnoea to confirm COPD.
  • Recognize overlapping symptoms such as breathlessness that may mask coexisting COPD or cardiovascular disease.

Management

  • Manage prevalent and incident cardiovascular diseases (heart failure, dyslipidaemia, hypertension, ischaemic heart disease, atrial fibrillation) in COPD patients according to clinical guidelines.
  • Address COPD exacerbation risk to reduce overall cardiopulmonary risk.
  • Enhance integration between cardiology, pulmonology, and primary care specialists for comprehensive management.

Monitoring & Follow-up

  • Regularly assess cardiopulmonary risk factors and disease progression in COPD patients.
  • Monitor for exacerbations of COPD and cardiovascular events to adjust treatment accordingly.

Risks

  • Underdiagnosis and undertreatment of cardiovascular disease in COPD patients increase risk of adverse cardiopulmonary events.
  • Shared symptoms may delay diagnosis and treatment of either condition, worsening prognosis.

Patient & Prescribing Data

Individuals with COPD and coexisting cardiovascular risk factors or disease

Treatment should be aligned with clinical guidelines for both COPD and cardiovascular diseases, emphasizing prevention of exacerbations and cardiovascular events through multidisciplinary care.

Clinical Best Practices

  • Use spirometry proactively in patients with cardiovascular risk factors and respiratory symptoms to identify COPD.
  • Apply guideline-directed management for cardiovascular comorbidities in COPD patients.
  • Promote multidisciplinary collaboration among pulmonologists, cardiologists, and primary care providers.
  • Focus on reducing COPD exacerbations to lower cardiopulmonary risk.
  • Recognize and address the bidirectional under-recognition of COPD and cardiovascular disease.

References

Original Source(s)

Identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease: a multidisciplinary consensus and modified Delphi study

  • by Chris P Gale, John R Hurst, Nathaniel M Hawkins, Jean Bourbeau, MeiLan K Han, Carolyn S P Lam, Darcy D Marciniuk, David Price, Daiana Stolz, Ty Gluckman, Shelley Zieroth, Ramesh Nadarajah, Robert P Young, Dave Singh, Fernando J Martinez, David D Berg, Mohit Bhutani, the Global Working Group on Cardiopulmonary Risk, Amr Abdin, Dzifa Ahadzi, Albert B Albay, Bernardino Alcázar Navarrete, Luís Alves, Sameera Ansari, Antonio Anzueto, Felix Barasa, David D Berg, Andy Bevan, Mohit Bhutani, Giuseppe Biondi-Zoccai, Jean Bourbeau, Raffaele Bugiardini, Daniela Calderaro, Arturo Cortes-Telles, Michael G Crooks, Diego F Echazarreta, Nabil Farag, Fredrico L A Fernandes, Frits M E Franssen, Suzanne Fredericks, Chris P Gale, Olga M García Morales, Maria C Gaviria, Baris Gencer, Gonzalo Ernesto Gianella Malca, Kari Hanne Gjeilo, Ty Gluckman, Martha Gulati, MeiLan K Han, Nathaniel M Hawkins, Jeroen M Hendriks, John R Hurst, Anh-Thu Huynh Dang, Majdy M Idrees, Tobin Joseph, Nadim Kanj, Ee Ming Khoo, Bruce Kirenga, Leonie Klompstra, Martha Kyriakou, Carolyn S P Lam, Bouchra Lamia, Le Thi Tuyet Lan, Dominik Linz, Angela H E M Maas, Darcy D Marciniuk, Fernando J Martinez, Angela Massouh, Walter Mattarucco, Renata G Mendes, Anant Mohan, Trine Moholdt, Majid Mokhtari, Felicia Montero-Arias, Claudia Münks-Lederer, Shigeo Muro, Ramesh Nadarajah, Kazuhiro Nakao, Yoko M Nakao, Thu Nguyen Ngoc Phuong, Johanna O’Callaghan, Demosthenes Panagiotakos, Alberto Papi, Gerardo Payro, Massimo Piepoli, Marija Polovina, Bogdan A Popescu, David Price, Hany I Ragy, Keerthenan Raveendra, Christopher M Reid, Catherine Reynolds, Antonio Luiz P Ribeiro, Richard E K Russell, Lavanya Saiva, Juliana Salas Segura, Julie Sanders, Raewyn J Scott, Terence Seemungal, Dinesh Shrikrishna, Sami O Simons, Dave Singh, Yuanlin Song, Daiana Stolz, Abirami Subramaniam, Yongchang Sun, Raj Thakkar, Frederik Trinkmann, Izabella Uchmanowicz, Viola Vaccarino, Lowie E G W Vanfleteren, Rajesh Vedanthan, Tonya Winders, Jianhua Wu, Robert P Young, Jinping Zheng, Min Zhou, Shelley Zieroth

  • March 3, 2025

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