Identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease: a multidisciplinary consensus and modified Delphi study
- PMID: 40037333
- DOI: 10.1093/eurjpc/zwaf119
Identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease: a multidisciplinary consensus and modified Delphi study
Abstract
Aims: Cardiovascular disease is a common comorbidity in chronic obstructive pulmonary disease. Yet, cardiovascular disease and risk are underdiagnosed in chronic obstructive pulmonary disease and are often undertreated, increasing the risk of cardiopulmonary events.
Methods and results: We formed a Global Working Group of experts in chronic obstructive pulmonary disease and cardiovascular disease to produce a consensus statement detailing the identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease. We conducted virtual meetings supplemented by remote working and communication. The Chairs (C.P.G., M.B.) proposed a draft consensus statement, which was further developed by the Global Working Group. The selection of the final consensus statement and key points were obtained using the modified Delphi method. The consensus statement is, 'Given the high burden of fatal and non-fatal major cardiovascular and respiratory events in patients with COPD it is important that cardiopulmonary risk is assessed and managed'. Patients with cardiovascular risk factors or disease who have regular cough or expectoration, recurrent 'chest infections', a significant smoking history, or dyspnoea should complete spirometry to confirm the presence of chronic obstructive pulmonary disease. Prevalent and incident cardiovascular disease and risk in patients with chronic obstructive pulmonary disease, including heart failure, dyslipidaemia, hypertension, ischaemic heart disease, and atrial fibrillation, should be managed according to clinical guidelines. In addition, chronic obstructive pulmonary disease exacerbation risk in patients with chronic obstructive pulmonary disease should be addressed to reduce cardiopulmonary risk. Enhanced integration with specialists in cardiology, pulmonology, and primary care is recommended.
Conclusion: The identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease are an unmet public health need that can be addressed through shared understanding and multidisciplinary working to improve cardiopulmonary outcomes.
Keywords: Cardiopulmonary risk; Cardiovascular disease; Chronic obstructive pulmonary disease.
Plain language summary
This paper, produced by the Global Working Group of experts in chronic obstructive pulmonary disease and cardiovascular disease, is about the identification and management of cardiopulmonary risk in patients with chronic obstructive pulmonary disease.Individuals with cardiovascular risk factors or disease who have a regular cough or expectoration, recurrent ‘chest infections’, a significant smoking history, or breathlessness should complete spirometry to confirm the presence of chronic obstructive pulmonary disease.Cardiovascular disease and risk in individuals with chronic obstructive pulmonary disease, including heart failure, dyslipidaemia, hypertension, ischaemic heart disease, and atrial fibrillation, should be managed according to clinical guidelines.Identifying cardiopulmonary risk to prevent exacerbations of chronic obstructive pulmonary disease, treat established cardiovascular disease, and reduce cardiovascular risk in patients with chronic obstructive pulmonary disease offers the prospect to improve cardiopulmonary outcomes.
© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.
Conflict of interest statement
Conflict of interest: There are no declarations with respect to this manuscript. Outside this work: A. Abdin reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Boston Scientific and Bayer GmbH. A.B.A. reports honoraria for lectures from AstraZeneca, GlaxoSmithKline, and Pfizer; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as a member of the Board of Trustees for the Philippine College of Chest Physicians. B.A.N. reports grants or contracts from AstraZeneca and GlaxoSmithKline; consulting fees from AstraZeneca, GlaxoSmithKline, and Sanofi; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Zambon, and MSD; support for attending meetings and/or travel from Menarini, Sanofi, and AstraZeneca. L.A. reports consulting fees from AstraZeneca, Merck Sharp & Dohme, and GlaxoSmithKline; support for attending meetings and/or travel from Boehringer Ingelheim, Mylan LDA, and BIAL. S.A. reports research grants from the Australian Government Department of Health Medical Research Future Fund and Royal Australian College of General Practitioners; consulting fees from WHO Western Pacific Regional Office (WPRO), Division of Pacific Technical Support (DPS); honoraria from Asthma Australia, National Health and Medical Research Council, and Macquarie University Faculty of Medicine; sponsorship for travel and accommodation from Asthma Australia; secretariat role for the Pacific Health Information Health Network; other financial or non-financial interests as their academic appointment at UNSW Sydney are salaried through two Australian Government Medical Research Future Fund grants. A. Anzueto reports consulting fees from GlaxoSmithKline, AstraZeneca, and Sanofi/Regeneron; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from GlaxoSmithKline, AstraZeneca, and Viatrix Pharmaceutical. D.D.B. reports grants or contracts from Pfizer and AstraZeneca; consulting fees from AstraZeneca, Pfizer, Mobility Bio, Inc., and Youngene Therapeutics; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Medical Education Speakers Network (MESN) and USV Private Limited; participation on a data safety monitoring board or advisory board for AstraZeneca, Beckman Coulter (CEC), Kowa Pharmaceuticals (CEC), and Tosoh Biosciences (CEC). M.B. reports grants or contracts from AstraZeneca, GlaxoSmithKline, Sanofi, Mereo Pharma, Takeda, Covis Pharma, and Valeo; consulting fees from AstraZeneca, GlaxoSmithKline, Sanofi, Mereo Pharma, Takeda, Covis Pharma, and Valeo; support for attending meetings and/or travel from AstraZeneca; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid via a position with Canadian Thoracic Society Executive and Board of Directors. G.B.Z. reports consulting fees from Aleph, Amarin, Balmed, Cardionovum, Crannmedical, Endocore Lab, Eukon, Guidotti, Innovheart, Meditrial, Menarini, Microport, Opsens Medical, Terumo, and Translumina. J.B. reports grants or contracts from Canadian Institute of Health Research (CIHR), Réseau en santé respiratoire du FRQS, McGill University, McGill University Health Centre Foundation, AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Grifols, Novartis, Sanofi, and Trudell Canada Ltd; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Trudell Canada Ltd, Pfizer Canada Ltd, and COVIS Pharma Canada Ltd. R.B. reports participation on the data safety monitoring board of Aptabio Therapeutics, Inc. D.C. reports consulting fees from Bayer and AstraZeneca; payment or honoraria for educational events from Bayer, AstraZeneca, and Lilly; support for attending meetings and/or travel from Bayer, Novartis, and AstraZeneca; participation on a data safety monitoring board or advisory board. A.C.T. reports honoraria for lectures and presentations from AstraZeneca, GlaxoSmithKline, Chiesi, and Johnson & Johnson; participation on advisory boards for AstraZeneca and GlaxoSmithKline. 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D.F.E. reports grants or contracts from Boehringer Ingelheim; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Boehringer Ingelheim; payment for expert testimony from Merk Sharp Dome; support for attending meetings and/or travel Boehringer Ingelheim. F.L.A.F. reports consulting fees from GlaxoSmithKline, Boehringer Ingelheim, AstraZeneca, Sanofi, and ACHE; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from GlaxoSmithKline, Boehringer Ingelheim, AstraZeneca, Sanofi, and ACHE; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid with the Brazilian Respiratory Society. F.M.E.F. reports grants or contracts from AstraZeneca, Boehringer Ingelheim, TEVA, and Chiesi; consulting fees from AstraZeneca, Chiesi, Sanofi, and Verona Pharma; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Chiesi, and GlaxoSmithKline; support for attending meetings and/or travel from AstraZeneca and Chiesi; receipt of equipment, materials, drugs, medical writing, gifts, or other services from Novartis and Chiesi. C.P.G. reports grants or contracts from Alan Turing Institute, British Heart Foundation, National Institute for Health Research, Horizon 2020, Abbott Diabetes, Bristol Myers Squibb, and European Society of Cardiology; consulting fees from AI Nexus, AstraZeneca, Amgen, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, CardioMatics, Chiesi, Daiichi Sankyo, GPRI Research B.V., Menarini, Novartis, iRhythm, Organon, and The Phoenix Group; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Boston Scientific, Menarini, Novartis, Raisio Group, Wondr Medical, and Zydus; support for attending meetings and/or travel from AstraZeneca; participation on a data safety monitoring board or advisory board with DANBLOCK trial and TARGET CTCA trial; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as Deputy Editor of EHJ Quality of Care and Clinical Outcomes, member of NICE Indicator Advisory Committee and Chair of ESC Quality Indicator Committee; stock or stock options with CardioMatics; receipt of equipment, materials, drugs, medical writing, gifts, or other services from Kosmos. 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N.M.H. reports consulting fees from AstraZeneca; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Boehringer Ingelheim, and Novo-Nordisk. J.R.H. reports grants or contacts from AstraZeneca; consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Sanofi, and Takeda; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Sanofi, and Takeda; support for attending meetings and/or travel from AstraZeneca. M.I. reports speaking/presentation honoraria from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Sanofi, Bayer, Hikma, Sudair, Ferrer, Novartis, Merk, and Janssen; support for attending meetings and/or travel from Ferrer, Janssen, Hickma, AstraZeneca, and GlaxoSmithKline; participation on a data safety monitoring board or advisory board with AstraZeneca, GlaxoSmithKline, Sanofi, Bayer, Janssen, Merk, and Ferrer; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid with the Saudi Thoracic Society and the Saudi Association of Pulmonary Hypertension. T.J. reports speakers honoraria from Janssen and authors payment from Medicine Journal. 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L.K. reports leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as President-elect of Association of Cardiovascular Nurses and allied Professionals (ACAP) within the European Society of Cardiology and Chair patient of Heart and Lung patient organization Linköping in Sweden. C.S.P.L. reports grants or contracts from National Medical Research Council of Singapore, Novo Nordisk, and Roche Diagnostics; consulting fees from Alleviant Medical, Allysta Pharma, AnaCardio AB, Applied Therapeutics, AstraZeneca, Bayer, Biopeutics, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, CardioRenal, CPC Clinical Research, Eli Lilly, Impulse Dynamics, Intellia Therapeutics, Ionis Pharmaceutical, Janssen Research & Development LLC, Medscape/WebMD Global LLC, Merck, Novartis, Novo Nordisk, Prosciento Inc, Quidel Corporation, Radcliffe Group Ltd., Recardio Inc, ReCor Medical, Roche Diagnostics, Sanofi, Siemens Healthcare Diagnostics, and Us2.ai; patents planned, issued or pending PCT/SG2016/050217 and US Patent No. 10,702, 247; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid with Us2.ai; stock or stock options from Us2.ai. B.L. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, MSD, and GlaxoSmithKline; support for attending meetings and/or travel from AstraZeneca and Chiesi; participation on a data safety monitoring board or advisory board with AstraZeneca and Chiesi; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as a member of the French respiratory society board. L.T.T.L. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, GlaxoSmithKline, and Boehringer Ingelheim. D.L. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Biosense, Zoll, CardioFocus, Biotronik, Ablacon, and Bayer. A.H.E.M.M. reports consulting fees from Organon and Abbott; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Organon, Omron, and Philips. D.D.M. reports grants or contracts from AstraZeneca, Boehringer Ingelheim, Canadian Institute of Health Research, GlaxoSmithKline, Grifols, Lung Association of Saskatchewan, Lung Health Institute of Canada, McGill University, Novartis, Sanofi, Saskatchewan Health Research Foundation, and Schering-Plough; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Canadian Thoracic Society, American College of Chest Physicians, American Thoracic Society; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid from Saskatchewan Health Research Foundation and CHEST Journal; other financial or non-financial interests as an employee at University of Saskatchewan. F.J.M. reports grants or contracts from AstraZeneca, Chiesi, GlaxoSmithKline, Sanofi/Regeneron, NHLBI—AstraZeneca, Chiesi, Boehringer-Ingelheim, GlaxoSmithKline, Novartis, Polarean, Sanofi/Regeneron, Sunovion, and TEVA Pharmaceuticals; consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, GlaxoSmithKline, Novartis, Polarean, Pulmonx, Sanofi/Regeneron, Sunovion, Teva, Theravance/Viatris, and UpToDate; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca and GlaxoSmithKline; participation on a Data Safety Monitoring Board or Advisory Board with MedTronic and GlaxoSmithKline. W.M. reports leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as President of Asociación Argentina de Medicina Respiratoria. R.G.M. reports support for attending meetings and/or travel from Fundação de Amparo à Pesquisa do Estado de São Paulo. T.M. reports grants or contracts from Novo Nordisk Foundation, European Commission, and The Regional Health Authority in Central Norway; honoraria for lecture from Norwegian School of Sport Science; support to attend meeting from European Association for Preventive Cardiology, Swedish Sports Medicine Society, Puijo symposium, and Kupio Research Institute of Exercise Medicine; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid with European Association for Preventive Cardiology. F.M.A. reports grants or contracts from AstraZeneca, Novartis, Moderna, and PPD; payment or honoraria for lectures and presentations from AstraZeneca, GlaxoSmithKline, Roche, Novartis, and Ferrer; support for attending meetings and/or travel from AstraZeneca, GlaxoSmithKline, Novartis, and Ferrer; participation on a Data Safety Monitoring Board or Advisory Board with AstraZeneca, GlaxoSmithKline, Novartis, and Roche; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as President of the Costa Rican Thoracic Society; receipt of equipment, materials, drugs, medical writing, gifts, or other services from AstraZeneca. C.M.L. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Boehringer Ingelheim, and Berlin Chemie; support for attending meetings and/or travel from AstraZeneca, Boehringer Ingelheim, Berlin Chemie, and Insmed; participation on a Data Safety Monitoring Board or Advisory Board with AstraZeneca, Boehringer Ingelheim, and Berlin Chemie; stock or stock options with GlaxoSmithKline; receipt of equipment, materials, drugs, medical writing, gifts, or other services from AstraZeneca. S.M. reports grants or contracts from ROHTO Pharmaceutical Co. Ltd and CHUGAI Pharmaceutical Co. Ltd; consulting fees from AstraZeneca K.K. and GlaxoSmithKline in Japan; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Nippon Boehringer Ingelheim Co. Ltd, AstraZeneca K.K., and GlaxoSmithKline in Japan; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as Senior Director of the Japanese Respiratory Society. K.N. reports grants or contracts from Meiji Yasuda Life Insurance Company. Y.M.N. reports grants or contracts from Bayer. J.O.C. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Novartis, and Boehringer Ingelheim; support for attending meetings and/or travel from Novartis, Boehringer Ingelheim, and A. Menarini; participation on a Data Safety Monitoring Board or Advisory Board with Chiesi; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as a member of Clinical Advisory Group with the Asthma Society of Ireland. A.P. reports grants or contracts from Chiesi, AstraZeneca, GlaxoSmithKline, and Sanofi; consulting fees from Chiesi, AstraZeneca, GlaxoSmithKline, Sanofi, Avillion, Moderna, and Roche; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Chiesi, AstraZeneca, GlaxoSmithKline, Menarini, Zambon, Mundipharma, Sanofi, Iqvia, Avillion, Sanofi, Regeneron, and Zambon; participation on a Data Safety Monitoring Board or Advisory Board with Chiesi, AstraZeneca, GlaxoSmithKline, Sanofi, Iqvia, Avillion, and Moderna. G.P. reports consulting fees from VIATRIS Mexico and Menarini; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from VIATRIS, Novartis, Bayer, Pfizer, and Menarini; support for attending meetings and/or travel from Pfizer; participation on a Data Safety Monitoring Board or Advisory Board with Bayer. M. Piepoli reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Boehringer Ingelheim, Novo Nordisk, Menarini, and Servier; support for attending meetings and/or travel from Novo Nordisk; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as European Society of Cardiology Vice President. M. Polovina reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Boehringer Ingelheim, AstraZeneca, Novartis, Pfizer, Pharmaswiss, and Hemofarm/STADA; support for attending meetings and/or travel from Hemofarm/STADA. D. Price reports grants or contracts from AstraZeneca, Chiesi, Viatris, Novartis, Regeneron Pharmaceuticals, Sanofi Genzyme, and United Kingdom National Health Service; consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Teva Pharamaceuticals, and Viatris; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, Inside Practice, GlaxoSmithKline, Novartis, Medscape, Regeneron Pharmaceuticals, Sanofi Genzyme, Teva Pharmaceuticals, and Viatris; payment for expert testimony from GlaxoSmithKline; support for attending meetings and/or travel from AstraZeneca, Boehringer Ingelheim, Novartis, Medscape, and Teva Pharmaceuticals; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid from AstraZeneca, Amgen, Boehringer Ingelheim, Chiesi, Novartis, Regeneron Pharmaceuticals, Sanofi Genzyma, Teva Pharmaceuticals, and Viatris; stock or stock options with AKL Research and Development Ltd, Optimum Patient Care Ltd (Australia and UK), Observational and Pragmatic Research Institute Pte Ltd (Singapore), 5% shareholding in Timestamp which develops adherence monitoring technology; other financial or non-financial interests with UK Efficacy and Mechanism Evaluation programme and Health Technology Assessment. 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J.S. reports grants or contracts from National Institute of Health Research and Barts Charity; support for attending meetings and/or travel from European Society of Cardiology; participation on a Data Safety Monitoring Board or Advisory Board as part of VAL-CARD study data monitoring committee; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as ESC ACNAP science committee chair (2020-24), The Aortic Dissection Charitable Trust Research Advisory Group (2021-23), Society of Cardiothoracic Surgery Ambassador, and NIHR Doctoral and Clinical Practitioner Academic Fellowship (2022–). 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Shrikrishna reports honoraria for lectures, presentations, and educational events from GlaxoSmithKline, AstraZeneca, Chiesi, Boehringer Ingelheim, Bayer, BMS, TEVA, and Pfizer; support for attending meetings and/or travel from AstraZeneca; participation on a Data Safety Monitoring Board or Advisory Board with Chiesi; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as Co-chair of UK Cardiopulmonary Taskforce which is funded by Astra Zeneca; receipt of equipment, materials, drugs, medical writing, gifts, or other services from AstraZeneca. S.O.S. reports grants or contracts from Roche, Dutch Research Council (NWO) and Lung Foundation Netherlands (Longfonds); consulting fees from AstraZeneca, Chiesi, and GlaxoSmithKline; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca and Chiesi; support for attending meetings and/or travel from AstraZeneca and Chiesi. D. Singh reports consulting fees from Aerogen, AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, CSL Behring, EpiEndo, Genentech, GlaxoSmithKline, Glenmark, Gossamer Bio, Kinaset Therapeutics, Menarini, Novartis, Orion, Pulmatrix, Sanofi, Synairgen, Teva, Theravance Biopharma, and Verona Pharma. D. Stolz reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Berline-Chemie/Menarini, Boehringer Ingelheim, Chiesi, CSL Behring, Curetis AG, GlaxoSmithKline, Merck, MSD, Novartis, Sanofi, Vifor, and Roche; participation on a Data Safety Monitoring Board or Advisory Board with AstraZeneca, Berline-Chemie/Menarini, Boehringer Ingelheim, Chiesi, CSL Behring, Curetis AG, GlaxoSmithKline, Merck, MSD, Novartis, Sanofi, Vifor, and Roche; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as current GOLD representative for Switzerland. R.T. reports consulting fees from AstraZeneca, Bayer, Novartis, and Omron; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Daiichi Sankyo, Bayer, Novartis, and Edwards; support for attending meetings and/or travel from AstraZeneca and Bayer; participation on a Data Safety Monitoring Board or Advisory Board with Abbott, Boehringer Ingelheim, and AstraZeneca; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid as President of Primary Care Cardio Society, Board Observer of British Society of Heart Failure, UK Clinical Director of Healthy.io and cardiac expert advisory groups with NHSE; stock or stock options with Healthy.io; receipt of equipment, materials, drugs, medical writing, gifts, or other services from Reister; other financial or non-financial interests with Avegen. F.T. reports consulting fees from AstraZeneca, Berlin Chemie, Boehringer Ingelheim, GlaxoSmithKline, Merck Healthcare, Novartis, Omron, OM-Pharma, Roche, Sanofi-Aventis, and Thorasys; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events AstraZeneca, Berlin Chemie, Boehringer Ingelheim, Bristol-Myers Squibb, Fisher & Paykel, GlaxoSmithKline, Janssen-Cilag, Merck Healthcare, Novartis, Omron, OM-Pharma, Roche, Sanofi-Aventis, Thorasys, Pfizer, TEVA, Actelion, and Mundipharma. L.E.G.W.V. reports grants or contracts from The Family Kamprad Foundation, the Swedish government and country council ALF grant, The Swedish Heart and Lung Foundation, and Svensk Lungmedicinsk Förening; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events GlaxoSmithKline, AstraZeneca, Boehringer, Novartis, Chiesi, Resmed, Pulmonx, and Grifols. T.W. reports consulting fees from AZ, Chiesi, GlaxoSmithKline, Novartis, MSD, Roche, and Sanofi Regeneron; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AZ, Chiesi, GlaxoSmithKline, Novartis, MSD, Roche, and Sanofi Regeneron. R.P.Y. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca and GlaxoSmithKline; support for attending meetings and/or travel from GlaxoSmithKline; patents planned, issued or pending with Synergenz BioScience Ltd; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid with Asthma and Respiratory Foundation of New Zealand (NZ); stock or stock options with Synergenz BioScience Ltd. J.Z. reports consulting fees from AstraZeneca; honoraria for presentations from AstraZeneca; participation on a Data Safety Monitoring Board or Advisory Board with AstraZeneca. S.Z. served on advisory boards for, or speaker engagements with Abbott, AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Cytokinetics, Eli Lilly, GSK, Medtronic, Merck, Novartis, Novo-Nordisk, Pfizer, and Vifor Pharma; and serves on a clinical trial committee or as a national lead for studies sponsored by AstraZeneca, Boehringer Ingelheim, Merck, Novartis, Pfizer, and Salubris Bio; and participation on a Data Safety Monitoring Board or Advisory Board with Pfizer. D.A.; F.B.; A.B.; N.F.; S.F.; M.C.G.; B.G.; G.E.G.M.; K.H.G.; J.M.H.; A.T.H.D.; N.K.; B.K.; M.K.; A. Massouh; A. Mohan; M.M.; R.N.; T.N.N.P.; D. Panagiotakos; B.A.P.; H.I.R.; K.R.; C.M.R.; C.R.; A.L.P.R.; L.S.; J.S.S.; R.J.S.; Y. Song; A.S.; Y. Sun; I.U.; V.V.; R.V.; J.W.; M.Z. have nothing to declare.
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