Prevalence of chronic obstructive pulmonary disease (COPD) among smokers with stable coronary artery disease (CAD)

Abstract

Introduction: COPD and CAD are common chronic diseases with shared risk factors. COPD continues to be largely underdiagnosed and undertreated. We aimed to describe the prevalence of COPD in Tunisian smokers with CAD Methods: In a cross-sectional study, patients over 35 years of age who underwent coronary angiography for suspected CAD and reported ≥10 pack-year of cigarette smoking were recruited. Spirometry was undertaken for all participants, and COPD was defined according to GOLD criteria. The finding of ≥50% coronary luminal narrowing confirmed the presence of CAD Results: Spirometry was undertaken for 122 men with mean age of 59.3 years and mean pack-year of 52.3. Mean CAD follow-up duration was 3.9 years. Diabetes, hypertension and dyslipidemia were the most common comorbidities. One or more threatening coronary lesions were found in 50% of patients. Echocardiography was normal in 45.9% of patients. The prevalence of COPD was 19.7%. Of the 24 patients with COPD,17 patients were newly diagnosed. Six patients had mild COPD,15 had moderate COPD,2 had severe COPD and 1 had very severe COPD. The mean FEV1 in COPD patients was 68.7%. COPD-related symptoms were:chronic cough(56%), dyspnea(76%) and wheezes(28%). Pulmonary arterial hypertension was observed in 36% of COPD patients. The comparison of patients with COPD with those without COPD showed that respiratory symptoms, chest-X-ray abnormality and pulmonary arterial hypertension were significantly more frequent in COPD patients Conclusion: There was a high prevalence of COPD among patients with CAD and most were underdiagnosed despite being symptomatic. Smokers with CAD and respi­ratory symptoms should be evaluated for airflow limitation