Ischemic Heart Disease during Acute Exacerbations of COPD.

Rosa Malo de Molina,Piedad Ussetti,Manuel Valle,Carlos Arellano,Silvia Aguado

doi:10.3390/medsci6040083

Abstract

Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of acute cardiovascular events, and around 30% die from cardiovascular diseases. Recent data suggest an increased risk of myocardial infarction in the following days of a severe exacerbation of COPD. Disruption in the balance during the exacerbation with tachycardia, increased inflammation and systemic oxidative stress as well as some other factors may confer an increased risk of subsequent cardiovascular events. A number of investigations may be useful to an early diagnosis, including electrocardiography, imaging techniques and blood test for biomarkers. Some drugs that have changed prognosis in the cardiovascular setting such as cardioselective beta-blockers may be underused in patients with COPD despite its demonstrated benefits. This review focuses on several aspects of exacerbation of COPD and cardiovascular events including epidemiology, possible mechanism, diagnosis and treatment.

Highlights

Patients with chronic obstructive pulmonary disease (COPD) often develop cardiovascular comorbidities [1]
Focusing on ischemic heart disease, a recent meta-analysis showed that patients with COPD had a consistent risks of coronary heart disease (meta-odd ratio (OR) 186, 95% confidence interval (CI)
The purpose of this review is to summarize current knowledge relating to epidemiology, diagnosis and treatment of ischemic heart disease in people with Acute Exacerbation of COPD (AECOPD) and the mechanisms that may underlie its coexistence

Summary

Introduction

Patients with chronic obstructive pulmonary disease (COPD) often develop cardiovascular comorbidities [1]. They have a higher risk of acute cardiovascular events, and around 30%. COPD patients with acute ischemic heart diseases (IHD) may have worse outcomes. The three-year follow-up of 4284 patients who received hospital treatment for coronary heart disease reported mortality rates of 21% for patients diagnosed with COPD versus 9% in those without COPD (p ≤ 0.001) [5]. COPD patients who develop ST-segment elevation myocardial infarction (STEMI) at three-year follow-up had higher mortality than non-COPD patients in a web-based Italian registry of

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