Association Between Rapid Lung Function Decline and Cardiovascular Outcomes: Analysis from the Community-based Prospective Ansan-Ansung Cohort in Korea

초록

Background and Aims: The impact of a rapid lung function decline, as assessed by repeated lung function assessments, on cardiovascular outcomes remains uncertain. Methods: We used data from the Ansan-Ansung cohort, a community-based population cohort. We included 6212 individuals with a median of six lung function measurements over 12 years. Exposure was rapid lung function decline (RLFD), defined as an annual decline in forced expiratory volume in 1 second of greater than 60 mL/year. The outcomes were incident cardiovascular disease, including myocardial infarction, coronary artery disease, congestive heart failure, stroke, atrial fibrillation, and cardiovascular mortality. The risk was assessed using multivariable Cox regression or Fine-Gray subdistribution hazard models, as appropriate. Results: Of 6212 subjects, the proportion of RLFD was 16.9%. During the median follow-up duration of 13.5 and 15.7 years, 290 cases (4.7%) of cardiovascular disease and 56 deaths (0.9%) from cardiovascular causes were observed. The risk of incident cardiovascular disease was significantly higher in subjects with RLFD than in those without RLFD (adjusted hazard ratio [aHR]: 1.41; 95% confidence interval [CI]: 1.09–1.82). Subjects with RLFD also had a significantly increased risk of cardiovascular mortality compared with those without RLFD (adjusted subdistribution hazard ratio [aSHR]: 2.09; 95% CI: 1.08–4.05). Conclusion: Rapid lung function decline was associated with an increased risk of cardiovascular disease and cardiovascular mortality.