Mortality in COPD: Inevitable or Preventable? Insights from the Cardiovascular Arena

Figures & data

Figure 1 Trends in age-standardized death rates for the six leading causes of death in the United States, 1970–2002 ([5]). Reproduced with permission from JAMA 2005; 294: 1255–1259 Copyright © 2005 American Medical Association.

Figure 2 Prevalence of statin use for secondary prevention in patients with myocardial infarction or angina ([8]).

Figure 3 Effect of acute exacerbations of COPD versus myocardial infarction on survival ([66], [67], [68], [69], [70]). FEV₁ = forced expiratory volume in 1 second, PCI = percutaneous coronary intervention, MI = myocardial infarction, COPD = chronic obstructive pulmonary disease.

Figure 4 Effect of budesonide-containing therapy (budesonide/formoterol or budesonide) versus reference therapy (formoterol or placebo) on mortality ([27]).

Figure 5 Survival benefit observed with ICS in COPD compared with that of the statins in coronary heart disease ([9], [23]). ICS = inhaled corticosteroids, ISEEC = Inhaled Steroid Effects Evaluation in COPD, 4S = Scandinavian Simvastatin Survival Study.

Table 1 Examples of NNTs for different drug classes

Drug class	Trial	NNT
Lipid-lowering drugs	Meta-analysis ([118])	69 for primary prevention of non-fatal MI or cardiovascular death
Aspirin	European Stroke Prevention Study ([119])	34 for secondary stroke prevention
ACE inhibitors	HOPE Trial ([120])	27 for cardiovascular events or death
Statins	4S Trial ([121])	17 for cardiovascular events, 30 for death
Salmeterol/fluticasone propionate	GOAL Study ([122])	10–20 for severe asthma exacerbation
Budesonide/formoterol	Halpin et al. ([31])	2.1–2.4 for COPD exacerbation requiring medical intervention
Salmeterol/fluticasone propionate	VIVACE Study ([107])	2.08 for moderate/severe exacerbation

ACE = angiotensin-converting enzyme; 4S = Scandinavian Simvastatin Survival Study; HOPE = Heart Outcomes Prevention Evaluation; GOAL = Gaining Optimal Asthma ControL.

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