Lung Function Abnormalities in Smokers with Ischemic Heart Disease

Franssen, Frits M.E.; Soriano, Joan B.; Roche, Nicolás; Bloomfield, Paul; Brusselle, Guy; Fabbri, Leonardo; García‐Río, Francisco; Kearney, Mark T.; Kwon, Namhee; Lundbäck, Bo; Rabe, Klaus F.; Raillard, Alice; Muellerova, Hana; Cockcroft, John R.

doi:10.1164/rccm.201512-2480oc

Cited by 63 publications

(41 citation statements)

References 42 publications

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“…Similarly, the prevalence of COPD is remarkably high among patients with established IHD (Table E3), but, as in HF, COPD is grossly underdiagnosed (128,129). According to recent data, airflow limitation was documented in 30.5% of patients with documented IHD, although largely undiagnosed (130). In the largest study to date among patients undergoing percutaneous coronary intervention, patients with concomitant COPD had a 30% increased risk of death and 20% higher rate of repeat revascularization at 1 year compared with patients with IHD without COPD (131).…”

Section: The Size Of the Problemmentioning

confidence: 95%

“…Patients with both disorders have poor prognostic features, such as older age, higher prevalence of previous MI, and more coronary artery vessels affected by atherosclerosis (132). Patients with IHD and airflow limitation have more respiratory symptoms and increased BMI-Obstruction-Dyspnea Index, Systematic Coronary Risk Evaluation score and Framingham risk score, compared with patients with IHD alone (130). Interestingly, along with higher cardiovascular mortality, patients with COPD with IHD are at increased risk of developing HF (133).…”

Section: Clinical Characteristics and Diagnostic Challengesmentioning

confidence: 99%

See 1 more Smart Citation

Chronic Obstructive Pulmonary Disease and Cardiac Diseases. An Urgent Need for Integrated Care

Roversi

Fabbri

Sin³

et al. 2016

Am J Respir Crit Care Med

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192

158

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Chronic obstructive pulmonary disease (COPD) is a global health issue with high social and economic costs. Concomitant chronic cardiac disorders are frequent in patients with COPD, likely owing to shared risk factors (e.g., aging, cigarette smoke, inactivity, persistent low-grade pulmonary and systemic inflammation) and add to the overall morbidity and mortality of patients with COPD. The prevalence and incidence of cardiac comorbidities are higher in patients with COPD than in matched control subjects, although estimates of prevalence vary widely. Furthermore, cardiac diseases contribute to disease severity in patients with COPD, being a common cause of hospitalization and a frequent cause of death. The differential diagnosis may be challenging, especially in older and smoking subjects complaining of unspecific symptoms, such as dyspnea and fatigue. The therapeutic management of patients with cardiac and pulmonary comorbidities may be similarly challenging: bronchodilators may have cardiac side effects, and, vice versa, some cardiac medications should be used with caution in patients with lung disease. The aim of this review is to summarize the evidence of the relationship between COPD and the three most frequent and important cardiac comorbidities in patients with COPD: ischemic heart disease, heart failure, and atrial fibrillation. We have chosen a practical approach, first summarizing relevant epidemiological and clinical data, then discussing the diagnostic and screening procedures, and finally evaluating the impact of lung-heart comorbidities on the therapeutic management of patients with COPD and heart diseases.

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Section: The Size Of the Problemmentioning

confidence: 95%

Section: Clinical Characteristics and Diagnostic Challengesmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease and Cardiac Diseases. An Urgent Need for Integrated Care

Roversi

Fabbri

Sin³

et al. 2016

Am J Respir Crit Care Med

Self Cite

192

158

View full text Add to dashboard Cite

show abstract

“…Using spirometric assessment for the diagnosis of COPD, recent data have shown that 5-11% of patients with ACS have comorbid COPD [16]. Another study using spirometric data in current and former smokers with stable CHD showed that 30.5% of these patients had airflow limitation compatible with COPD [17]. However, COPD is a disease affecting not only the airways but also the lung parenchyma, and the relative contributions of airway disease and parenchymal destruction vary from person to person, which is reflected in the new Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition of the disease [18].…”

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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“…The prevalence of COPD in patients with established chronic IHD ranges from 8 to 30% 33 , and once again it is largely (> 80%) undiagnosed 42 .…”

Section: Ischaemic Heart Diseasementioning

confidence: 99%

Chronic Respiratory Abnormalities in the Multi-Morbid Frail Elderly

Beghè¹,

Clini²,

Fabbri³

2017

BRN

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Two-thirds of people aged ≥65 years have multi-morbidity. Multi-morbidity includes both physical and mental health conditions, as anxiety and depression, that almost invariably affect patients with multiple symptomatic chronic diseases. Management of a patient with any of the chronic diseases that are part of multi-morbidity is not just the management of that single index disease, but must include the active search and proper treatment of concomitant chronic diseases. The presence of concomitant chronic diseases should not alter the management of the index disease (e.g., chronic obstructive pulmonary disease [COPD]), and concomitant chronic diseases should be treated according to single diseases guidelines regardless of the presence of the index disease, obviously with careful consideration that this choice implies complex management, polypharmacy and potential adverse effects. Preliminary management programs suggest that a holistic integrated approach might improve quality of life and reduce hospital admissions and death in these multimorbid patients. (BRN Rev. 2017;3:247-66)

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Lung Function Abnormalities in Smokers with Ischemic Heart Disease

Cited by 63 publications

References 42 publications

Chronic Obstructive Pulmonary Disease and Cardiac Diseases. An Urgent Need for Integrated Care

Chronic Obstructive Pulmonary Disease and Cardiac Diseases. An Urgent Need for Integrated Care

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

Chronic Respiratory Abnormalities in the Multi-Morbid Frail Elderly

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