Airway obstruction and the risk of major coronary event

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) associate with coronary mortality [1]. Yet, data about the association between COPD and acute myocardial infarction (MI) is indefinite [2]. Aims and objectives: To evaluate whether obstruction predicts with MI, coronary mortality, or both. Methods: We analysed the survey data of 5576 adult Finns who participated in a national health examination survey between 1978 and 1980, performed spirometry, had all necessary data, and were free from cardiovascular diseases at baseline. We followed up them through a record linkage with national registers until end of 2011. The main outcome was a major coronary event; i.e. hospitalisation for MI or coronary death, whichever occurred first. We specified obstruction by the lower limit of normal (LLN) categorisation. Results: In multivariate analysis adjusted for the potential confounding factors of coronary heart disease, the hazard ratios (HRs) with 95% confidence intervals (95% CIs, in brackets) of major coronary event, MI, and coronary death were 1.36 (0.99–1.86), 1.18 (0.75–1.86), and 1.76 (1.28–2.42), respectively, in those with obstruction compared with the others. However, in women aged 30–49 obstruction predicted major coronary event, the adjusted HR was 4.11 (1.68–10.04). Conclusions: In conclusion, obstruction seems to predict a major coronary event in younger women only, whereas it is independently of sex and age closely associated with the risk of coronary death.