Olga M. García-Morales, Departamento de Neumología, Fundación Santa Fe Bogotá, Bogotá. Colombia
Alejandro Casas-Herrera, Fundación Neumológica Colombiana, Bogotá, Colombia
Carlos Torres-Duque, Fundación Neumológica Colombiana, Bogotá, Colombia
Carlos Aguirre, Fundación Neumológica Colombiana, Bogotá, Colombia
Diego A. Pérez, Servicio de Neumología, Christus Health, Cali, Colombia
Robin Rada, Servicio de Neumología, Hospital Militar Central, Universidad Nueva Granada, Bogotá. Colombia
Liliana Fernández-Trujillo, Departamento de Medicina Interna, Fundación Valle del Lili, Cali, Colombia
Jaime A. Barreto, Servicio de Neumología, Instituto Neumológico del Oriente, Bucaramanga, Colombia
Isabel Palacios-Ortega, Servicio de Neumología, Clínica Imbanaco grupo Quironsalud, Armenia, Colombia
Tatiana Valencia, Servicio de Neumología, Hospital San Juan de Dios, Armenia, Colombia
Abraham Alí-Munive, Fundación Neumológica Colombiana, Bogotá, Colombia
Ricardo del Olmo, Departamento Diagnóstico y Tratamiento, Hospital María Ferrer, Buenos Aires, Argentina
Audrey Piotrostanalzki, Servicio de Neumología clinicentro Colsanitas, Armenia, Colombia
Luisa F. Manrique, Servicio de Neumología Centro de Medicina del Ejercicio y Rehabilitación Cardíaca S.A. CEMDE, Medellín, Colombia
Laura Duque-González, Servicio de Cardiología PUL.SOS, Medellín, Colombia
Álvaro M. Quintero- Ossa, Capítulo de Falla Cardíaca, Trasplante Cardíaco e Hipertensión Pulmonar, Asociación Sociedad Colombiana de Cardiología y Cirugía Cardiovascular, Bogotá; Departamento de Cardiología, Clínica CardioVid, Medellín; Colombia
Julio R. Zuluaga-Peña, Odds Epidemiology, Bogotá, Colombia
Juan P. Zuluaga-Peña, Odds Epidemiology, Bogotá, Colombia
Diana C. Bermúdez-Acosta, Odds Epidemiology, Bogotá, Colombia
Jahir A. Soto-Mora, Odds Epidemiology, Bogotá, Colombia
María C. Gaviria, Servicio de Cardiología PUL.SOS, Medellín, Colombia;; Servicio de Cardiología, Clínica Las Vegas, Medellín, Colombia
Introduction: Chronic obstructive pulmonary disease (COPD) is associated with higher cardiovascular risk, especially after exacerbations. However, cardiopulmonary and mortality risk stratification continues to be heterogeneous in clinical practice. Objective: To develop evidence-based guidelines, adapted to the Colombian healthcare system, for providing multidisciplinary evaluation, stratification, and management of cardiopulmonary risk in COPD patients. Methods: The Colombian Association of Pulmonology and Thoracic Surgery and the Colombian Society of Cardiology and Cardiovascular Surgery convened a multidisciplinary panel of 19 experts. Six questions were posed, and systematic literature reviews were conducted. The certainty of the evidence was evaluated with GRADE, and the recommendations were developed using an Evidence-to-Decision framework. A modified Delphi process was applied, along with formal voting using a nine-point Likert scale; ≥ 70% agreement was required to approve each recommendation. Results: The consensus developed recommendations for identifying high-risk subgroups, determining the prognostic value of exacerbations, and integrating clinical and functional variables with a selective use of biomarkers. It included considerations for pharmacological and nonpharmacological treatment, emphasizing cardiovascular safety, and also recommended targeted cardiovascular disease evaluation in the event of disproportionate symptoms, as well as tailored follow-up according to the individual risk profile. Conclusion: This consensus provides an evidence-based framework for evaluating and stratifying cardiopulmonary risk in COPD patients in Colombia, emphasizing early high-risk detection and comprehensive multidisciplinary treatment.
Keywords: COPD. Cardiovascular risk. Consensus. Colombia. Exacerbation. Mortality.
