The risk of acute exacerbations of chronic obstructive pulmonary disease following acute myocardial infarction

<bold>Background:</bold> There is increased risk of acute myocardial infarction (AMI) after acute exacerbations of chronic obstructive pulmonary disease (AECOPD) but it remains unclear whether incident AMI are associated with increased subsequent the risk of AECOPD. We sought to investigate the relationship between AMI on AECOPD to determine the risk of AECOPD following AMI. <bold>Methods:</bold> This retrospective study analyzed data from the TriNetX system to form cohorts of patients with COPD who had an emergency admission for chest pain. The cohort was divided into two groups based on the diagnosed with AMI or had chest pain. After forming these cohorts, we compared the risk of AECOPD at 1-30 days, 30–90 days, and 90–365 days after AMI to assess whether AMI is associated with an increased risk of AECOPD and to examine differences in risk across these time intervals. <bold>Results:</bold> After forming the cohorts, the AMI group consisted of 4,304 patients, while the non-AMI chest pain cohort included 33,465 patients. The risk of AECOPD was higher in the AMI group after adjusting for covariates (1-30 days HR: 1.64, 95% CI 1.28–2.09; 30–90 days HR: 1.24, 95% CI 1.02–1.51; 90–365 days HR: 1.20, 95% CI 1.05–1.37). Additionally, heart failure was found to be significantly associated with a higher risk of AECOPD compared to patients without heart failure in the AMI group (HR: 2.47, 95% CI 1.59–3.86). <bold>Conclusions:</bold> In patients with COPD, the occurrence of AMI is associated with a higher risk of AECOPD and risk persists up to a year after AMI. This increased risk is particularly pronounced in patients with heart failure.