Systemic inflammatory markers as predictors of cardiac complications in patients with comorbid course of chronic obstructive pulmonary disease and ischemic heart disease

The characteristics of comorbid chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) still remain very important. The systemic inflammation, leading to the major clinical and functional manifestations, plays a very important role in the genesis of this disease. The main attention is paid to preventive vaccination due to the important role of Streptococcus pneumonia in developing the relapse of COPD. The aim of the study is to examine the impact of 13-valent pneumococcal conjugate vaccine (PСV13) on the clinical and functional features of systemic inflammation in patients with COPD and IHD. Materials and methods. The study included 36 vaccinated patients with COPD and IHD and 42 non-vaccinated patients with COPD and IHD. We have analyzed the number of relapses of COPD and IHD, major adverse cardiac events, the number of admissions to hospital and of pneumonia cases and functional parameters. We have been monitoring the inflammatory markers, such as C-reactive protein (CRP), fibrinogen and procalcitonin. Results. The vaccine PСV13 allows achieving statistically significant reduction of the basic indicators of inflammation (such as CRP and fibrinogen: 12 and 20%, respectively) within a year of observation. The significant systemic inflammatory indicators show significant clinical manifestations of relapse of COPD and IHD. One year after receiving vaccination the patients will have not only statistically significant reduction of CRP and fibrinogen, but also will show statistically significant reduction of adverse cardiac events (4.3 times) and the number of admissions to hospital (2.6 times). Even more indicative results can be seen in the example of reducing relapses of COPD (9 times), the number of admissions to hospital (7.4 times) and pneumonia cases (6 times). Conclusions: 1. Such indicators of systemic inflammation as CRP and fibrinogen can play a role of predictors of adverse cardiac events in patients with comorbid course of COPD and IHD. 2. The dynamic monitoring of procalcitonin can be used as an additional highly informative method of assessing the probability of bacterial infection and the effectiveness of applied therapy. 3. The vaccine PKV13 allows reducing the level of systemic inflammation after 1 year of the application.

chronic obstructive pulmonary disease, ischaemic heart disease, preventive vaccination, systemic inflammatory markers