BACKGROUND: The EXAcerbations of COPD and their OutcomeS on CardioVascular disease (EXACOS-CV) multi-database studies have consistently shown an increased risk of serious cardiovascular event following COPD exacerbations, but with some risk temporality variations. EXACOS-CV results were meta-analysed to increase their generalisability and improve precision. METHODS: Studies conducted in Canada, the United States, Germany, the Netherlands, Spain, Italy, Japan and England were meta-analysed, amounting to 1 030 875 individuals. Generally, each study included individuals aged