Coronary lesions in patients with COPD (Global Initiative for Obstructive Lung Disease stages I&amp;ndash;III) and suspected or confirmed coronary arterial disease

Mota, Igor Larchert; Sousa, Antônio Carlos Sobral; Almeida, Maria Luíza Dória; Melo, Enaldo Vieira de; Ferreira, Eduardo José Pereira; Neto, José Barreto; Matos, Carlos José Oliveira de; Telino, Caio José Coutinho Leal; Souto, Maria Júlia Silveira; Oliveira, Joselina Luzia Menezes

doi:10.2147/copd.s162713

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…Patients in the COPD group were older and had a higher frequency of diabetes compared with those in the non-COPD group; however, COPD remained an independent predictor of long-term cardiovascular events even after adjusting for established risk factors for CAD such as age, gender, hypertension, diabetes, and dyslipidemia. Patients with COPD also had a higher frequency of CAD, mainly severe and multivessel, and the more advanced the degree of COPD, the greater the severity of the coronary lesions and the extent of calcification, as previously suggested by us 29 and others. 30 Epidemiologic studies have identified a strong association between COPD and CAD, leading to the proposition that patients with COPD might be at higher risk of developing CAD and vice versa.…”

Section: Discussionsupporting

confidence: 81%

Cardiovascular Prognosis of Subclinical Chronic Obstructive Pulmonary Disease in Patients with Suspected or Confirmed Coronary Artery Disease

Ferreira,

Cardoso,

de Matos

et al. 2023

COPD

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Background Chronic obstructive pulmonary disease (COPD) worsens prognosis in patients with coronary artery disease (CAD). However, the cardiovascular prognosis in patients with stable or mildly symptomatic COPD remains unclear. Here, we sought to determine the long-term cardiovascular events in patients with subclinical or early-stage COPD with concomitant CAD. Methods This was a longitudinal analytical study involving 117 patients with suspected or established CAD who underwent assessment of pulmonary function by spirometry and who were followed up for six years (March 2015–January 2021). The patients were divided into two groups, one comprising COPD (n=44) and the other non-COPD (n=73) patients. Cox regression was used to evaluate the association between COPD and cardiovascular events, with adjustment for the established CAD risk factors, and the effect size was measured by the Cohen test. Results COPD patients were older ( p =0.028), had a greater frequency of diabetes ( p =0.026), were more likely to be smokers ( p <0.001), and had higher modified Medical Research Council scores ( p <0.001). There was no difference between the groups regarding gender, body mass index, hypertension, dyslipidemia, family history of CAD, and type of angina. CAD frequency and the proportion of patients with severe and multivessel CAD were significantly higher among COPD than among non-COPD patients (all p <0.001). At six-year follow-up, patients with COPD were more likely to have experienced adverse cardiovascular events than those without COPD ( p <0.001; effect size, 0.720). After adjusting for established CAD risk factors, COPD occurrence remained an independent predictor for long-term adverse cardiovascular events (OR: 5.13; 95% CI: 2.29–11.50; p <0.0001). Conclusion COPD was associated with increased severity of coronary lesions and a greater number of adverse cardiovascular events in patients with suspected or confirmed CAD. COPD remained a predictor of long-term cardiovascular events in stable patients with subclinical or early-stage of COPD, independently of the established CAD risk factors.

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Section: Discussionsupporting

confidence: 81%

Cardiovascular Prognosis of Subclinical Chronic Obstructive Pulmonary Disease in Patients with Suspected or Confirmed Coronary Artery Disease

Ferreira,

Cardoso,

de Matos

et al. 2023

COPD

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“…There are evident epidemiologic data connecting COPD with CAD. In a cross-sectional study of patients with suspected CAD, patients with COPD had a significantly higher frequency of obstructive coronary lesions as compared with CAD patients without airflow limitation [31]. Additionally, the severity of airflow limitation correlated with coronary lesion size and quantity.…”

Section: Coronary Artery Disease In Copdmentioning

confidence: 99%

“…Spirometry tests, especially FEV1, and airflow obstruction defined as FEV1/FVC less than 0.70, for instance, have strong predictive potential for CAD. For every 10% decrease in FEV1, cardiovascular mortality was found to increase by about 28%, and even among individuals with severe airways obstruction, the leading causes of death are predominantly sequels of cardiovascular disease [31,32,33,34]. On the other side, studies investigating airflow limitation in patients with CAD are scarce, but the prevalence of obstructive ventilation in CAD patients might be underestimated in the literature [28].…”

Section: Coronary Artery Disease In Copdmentioning

confidence: 99%

The Role of Omega-3 Fatty Acids in the Setting of Coronary Artery Disease and COPD: A Review

et al. 2018

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Chronic obstructive pulmonary disease (COPD) is a growing healthcare concern and will represent the third leading cause of death worldwide within the next decade. COPD is the result of a complex interaction between environmental factors, especially cigarette smoking, air pollution, and genetic preconditions, which result in persistent inflammation of the airways. There is growing evidence that the chronic inflammatory state, measurable by increased levels of circulating cytokines, chemokines, and acute phase proteins, may not be confined to the lungs. Cardiovascular disease (CVD) and especially coronary artery disease (CAD) are common comorbidities of COPD, and low-grade systemic inflammation plays a decisive role in its pathogenesis. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) exert multiple functions in humans and are crucially involved in limiting and resolving inflammatory processes. n-3 PUFAs have been intensively studied for their ability to improve morbidity and mortality in patients with CVD and CAD. This review aims to summarize the current knowledge on the effects of n-3 PUFA on inflammation and its impact on CAD in COPD from a clinical perspective.

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“…In another study from Brazil, the prevalence of CHD was 88% among 101 COPD patients compared with 45% among 109 non-COPD controls [ 28 ]. In this study smoking habits varied greatly between study groups, and the prevalence of CHD in both groups were quite high.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with coronary heart disease in COPD patients and controls

et al. 2022

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Background COPD and coronary heart disease (CHD) frequently co-occur, yet which COPD phenotypes are most prone to CHD is poorly understood. The aim of this study was to see whether COPD patients did have a true higher risk for CHD than subjects without COPD, and to examine a range of potential factors associated with CHD in COPD patients and controls. Methods 347 COPD patients and 428 non-COPD controls, were invited for coronary computed tomography angiography (CCTA) and pulmonary CT. Arterial blood gas, bioelectrical impedance and lung function was measured, and a detailed medical history taken. The CCTA was evaluated for significant coronary stenosis and calcium score (CaSc), and emphysema defined as >10% of total area <-950 Hounsfield units. Results 12.6% of the COPD patients and 5.7% of the controls had coronary stenosis (p<0.01), whereas 55.9% of the COPD patients had a CaSc>100 compared to 31.6% of the controls (p<0.01). In a multivariable model adjusting for sex, age, body composition, pack-years, CRP, cholesterol/blood pressure lowering medication use and diabetes mellitus, the OR (95% CI) for having significant stenosis was 1.80 (0.86–3.78) in COPD patients compared with controls. In a similar model, the OR (95% CI) for having CaSc>100 was 1.68 (1.12–2.53) in COPD patients compared with controls. Examining the risk of significant stenosis and CaSc>100 among COPD patients, no variable was associated with significant stenosis, whereas male sex [OR 2.85 (1.56–5.21)], age [OR 3.74 (2.42–5.77)], statin use [OR 2.23 (1.23–4.50)] were associated with CaSc>100, after adjusting for body composition, pack-years, C-reactive protein, use of angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), diabetes, emphysema score, GOLD category, exacerbation frequency, eosinophilia, and hypoxemia. Conclusion COPD patients were more likely to have CHD, but neither emphysema score, lung function, exacerbation frequency, nor hypoxemia predicted presence of either coronary stenosis or CaSc>100.

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Coronary lesions in patients with COPD (Global Initiative for Obstructive Lung Disease stages I–III) and suspected or confirmed coronary arterial disease

Cited by 9 publications

References 31 publications

Cardiovascular Prognosis of Subclinical Chronic Obstructive Pulmonary Disease in Patients with Suspected or Confirmed Coronary Artery Disease

Cardiovascular Prognosis of Subclinical Chronic Obstructive Pulmonary Disease in Patients with Suspected or Confirmed Coronary Artery Disease

The Role of Omega-3 Fatty Acids in the Setting of Coronary Artery Disease and COPD: A Review

Factors associated with coronary heart disease in COPD patients and controls

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