The Association between Chronic Obstructive Pulmonary Disease and Coronary Artery Disease in Patients Undergoing
Yongzhe Hong1,2, Michelle M Graham1, Danielle Southern3
1a Department of Medicine and Mazankowski Alberta Heart Institute , University of Alberta , Edmonton , Alberta , Canada.
Insights
This study found that chronic obstructive pulmonary disease (COPD) is negatively associated with coronary artery disease (CAD) in patients undergoing angiography. Further cardiac evaluation is recommended for COPD patients to prevent early mortality.
Area of Science:
- Cardiology
- Pulmonology
- Epidemiology
Background:
- Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are significant causes of mortality.
- Existing research on the association between COPD and CAD yields conflicting results.
Purpose of the Study:
- To investigate the relationship between COPD and angiographically diagnosed CAD within a population-based cohort.
- To quantify the association between COPD and the presence of significant coronary artery stenosis.
Main Methods:
- Retrospective analysis of the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry.
- Inclusion of adult patients who underwent coronary angiography between April 2007 and March 2014.
- Logistic regression models (univariable and multivariable) were used to assess the association, controlling for multiple cardiovascular risk factors.
Main Results:
- A cohort of 26,137 patients was analyzed, with 74.8% being male and a mean age of 63.3 years.
- Patients with COPD showed a crude odds ratio (OR) of 0.83 (95% CI 0.74-0.92) for having CAD.
- After adjusting for various risk factors, the adjusted OR for CAD in COPD patients was 0.75 (95% CI 0.67-0.84), indicating a negative association.
Conclusions:
- COPD is independently and negatively associated with the presence of coronary artery disease in patients undergoing coronary angiography.
- These findings highlight the complex interplay between respiratory and cardiovascular health.
- Recommendations include thorough cardiac assessment in COPD patients to mitigate premature mortality risks.
Abstract:
Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of morbidity and mortality. There are conflicting results regarding the association between COPD and CAD. We sought to measure the association between COPD and angiographically diagnosed CAD in a population-based cohort. We performed a retrospective analysis using data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH), a prospectively collected registry capturing all patients undergoing coronary angiography in Alberta, Canada, since 1995. We included adult patients who had undergone coronary angiogram between April 1, 2007 and March 31, 2014. CAD was present if at least one coronary artery had a significant stenosis ≥50%. COPD was present if the patient had a documented COPD history and was prescribed bronchodilators or inhaled steroids. We evaluated the association between COPD and CAD using univariable and multivariable logistic regression. There were 26,137 patients included with a mean age of 63.3 ± 12.2 years, and 19,542 (74.8%) were male. The crude odds ratio (OR) of having CAD was 0.83 (95% CI 0.74-0.92) for patients with COPD compared to those without COPD. The adjusted OR was 0.75 (95% CI 0.67-0.84) after controlling for age, sex, smoking history, body mass index, hypertension, diabetes, hyperlipidemia, peripheral artery disease and cardiac family history. In patients undergoing coronary angiography, COPD was negatively associated with CAD with and without the adjustment for classic risk factors. COPD patients should be properly examined for heart disease to reduce premature mortality.
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