Association of lung function with coronary heart disease and cardiovascular disease outcomes in elderly: The Rancho Bernardo study

Lee, Hwa Mu; Liu, Michael A.; Barrett‐Connor, Elizabeth; Wong, Nathan D.

doi:10.1016/j.rmed.2014.09.016

Cited by 44 publications

(31 citation statements)

References 26 publications

(23 reference statements)

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“…Finally, a feature more commonly observed in the late‐onset asthma phenotype is more severe and refractory lung disease with a more precipitous decline in lung function . Previous investigations have well characterized lung function as an independent predictor of CVD events …”

Section: Discussionsupporting

confidence: 52%

Late‐Onset Asthma Predicts Cardiovascular Disease Events: The Wisconsin Sleep Cohort

Tattersall

Barnet

Korcarz

et al. 2016

JAHA

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BackgroundAsthma is a heterogeneous syndrome with different clinical subtypes that is associated with an increased risk for cardiovascular disease (CVD). We hypothesized that the late‐onset subtype of asthma is associated with a higher risk of incident CVD.Methods and ResultsParticipants from the Wisconsin Sleep Cohort free of CVD at baseline were followed for a mean (SD) of 13.9 (5.9) years for development of CVD (myocardial infarction, angina, stroke, coronary revascularization, heart failure, or CVD death). Late‐onset asthma was defined as physician‐diagnosed asthma at age ≥18 years. Multivariable Cox regression models adjusted for age, sex, and CVD risk factors were used to assess associations of late‐onset asthma and incident CVD. The 1269 participants were 47.3 (8.0) years old; 166 participants had asthma (111 late‐onset, 55 early‐onset). Participants with late‐onset asthma compared to nonasthmatics were more likely to be female (67% versus 44%) and to have a higher body‐mass index (32.2 versus 29.4 kg/m2) (P<0.05). Mean age of asthma diagnosis in the late‐onset group was 39.5 (9.6) years versus 8.9 (5.7) years in the early‐onset group (P<0.0001). Late‐onset asthmatics had a higher adjusted risk of incident CVD than nonasthmatics (hazard ratio 1.57, 95% CI 1.01–2.45, P=0.045). There was no interaction between body‐mass index and age of asthma diagnosis on incident CVD (P=0.83).ConclusionsIn a large cohort study of adults followed prospectively for over a decade, late‐onset asthmatics had an increased risk of incident CVD events that persisted after adjustment for age, sex, and CVD risk factors.

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Section: Discussionsupporting

confidence: 52%

Late‐Onset Asthma Predicts Cardiovascular Disease Events: The Wisconsin Sleep Cohort

Tattersall

Barnet

Korcarz

et al. 2016

JAHA

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“…Some of these abnormalities (e.g., decreased FEV 1 and IVC) have separately been shown to be related to the incidence and outcomes of CHD independent of a COPD diagnosis [22][23][24]. Furthermore, significantly increased RV, TLC, and RV/TLC were also highly prevalent in our study, with > 30% of patients with AMI being hyperinflated.…”

Section: Discussionsupporting

confidence: 49%

“…A growing body of evidence suggests that, regardless of the presence of COPD, some discrete pulmonary function impairments are independently related to the incidence and prognosis of CHD [22][23][24]. Whole-body plethysmography in addition to blood gas analysis (arterial blood gases [ABGs]) allow a comprehensive evaluation of pulmonary impairments, including static and dynamic lung volumes as well as gas exchange.…”

Section: Whole-body Plethysmography and Blood Gas Analysis In Patientmentioning

confidence: 99%

Whole-Body Plethysmography and Blood Gas Analysis in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

et al. 2018

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Background: Chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD) often occur together. However, COPD is underdiagnosed among CHD patients. Objectives: This study investigated the prevalence of COPD and relevant pulmonary function test (PFT) impairments in patients with acute myocardial infarction (AMI). Methods: Patients undergoing coronary angiography for AMI were prospectively included. Body plethysmography, lung diffusing capacity, blood gas analysis, and echocardiography were performed. The following patient subgroups were compared: with versus without COPD, ST elevation myocardial infarction (STEMI) versus non-STEMI (NSTEMI). The prevalence of PFT impairments was also recorded. Results: A total of 100 patients (51 with NSTEMI, 49 with STEMI) were included. Twenty patients had diagnosed COPD, of whom 15 were diagnosed for the first time; 80% of all COPD patients were not receiving COPD therapy. Patients with COPD had higher maximum creatine kinase (p = 0.008) and troponin T (p = 0.054) levels than those without COPD. Hypoxaemia was more common in COPD patients (lower oxygen saturation [p = 0.008] and partial pressure of oxygen [PaO₂] [p = 0.005]). PaO₂ was significantly lower in STEMI compared with NSTEMI (p = 0.017). Independent of a COPD diagnosis, 65 patients had relevant PFT impairments. Conclusions: The high prevalence of undiagnosed COPD and relevant pulmonary function impairments in this cohort of patients with AMI, and the fact that pulmonary disease was untreated in the majority of COPD patients, highlight the importance of a general pulmonary workup of patients with AMI. Furthermore, patients with CHD should undergo screening for COPD, given the fact that COPD patients had larger infarction size.

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“…10–15, 18, 19 Asthma-related clinical variables (poor lung function, 30 IgE level, 31 allergic sensitization, 32 airborne pollen concentration, 33 and other atopic conditions 34 ) have been reported to be associated with the increased risks of similar CVD outcomes. However, previous studies were based on the broad and heterogeneous definitions of CVD and asthma and did not assess characteristics (heterogeneity) of asthma in relation to risk of MI.…”

Section: Discussionmentioning

confidence: 99%

Asthma Status and Risk of Incident Myocardial Infarction: A Population-Based Case-Control Study

Bang

Kim

et al. 2016

The Journal of Allergy and Clinical Immunology: In Practice

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Background The role of asthma status and characteristics of asthma in the risk of myocardial infarction (MI) are poorly understood. Objective We determined whether asthma and its characteristics are associated with risk of MI. Methods The study was designed as a population-based retrospective case-control study, which included all eligible incident MI cases between November 1, 2002, and May 31, 2006, and their matched controls. Asthma was ascertained using predetermined criteria. Active (current) asthma was defined as the occurrence of asthma-related episodes (asthma symptoms, use of asthma medications, unscheduled medical or emergency department visit, or hospitalization for asthma) within one year prior to MI index date. Results There were 543 eligible incident MI cases during the study period. Of the 543 MI cases, 81 (15%) had a history of asthma prior to index date of MI whereas 52 of 543 controls (10%) had such a history (adjusted odds ratio [OR]: 1.68; 95% CI: 1.06–2.66) adjusting for risk factors for MI and comorbid conditions (excluding chronic obstructive lung disease). While inactive asthma did not increase the risk of MI, individuals with active asthma had a higher odds of MI, compared to those without asthma (adjusted OR: 3.18; 95% CI: 1.57–6.44) without controlling for COPD. After adjusting for COPD, although asthma overall was no longer statistically significant (adjusted OR: 1.34, 95% CI: 0.84–2.15), active asthma still was associated (adjusted OR: 2.33, 95% CI: 1.12–4.82). Conclusion Active asthma is an unrecognized risk factor for MI. Further studies are needed to assess the role of asthma control and medications in the risk of MI.

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Association of lung function with coronary heart disease and cardiovascular disease outcomes in elderly: The Rancho Bernardo study

Cited by 44 publications

References 26 publications

Late‐Onset Asthma Predicts Cardiovascular Disease Events: The Wisconsin Sleep Cohort

Late‐Onset Asthma Predicts Cardiovascular Disease Events: The Wisconsin Sleep Cohort

Whole-Body Plethysmography and Blood Gas Analysis in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Asthma Status and Risk of Incident Myocardial Infarction: A Population-Based Case-Control Study

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