Early Detection of Chronic Obstructive Pulmonary Disease in Patients with Coronary Artery Disease

Wei-Chun Huang ； Chia-Hung Chen ； Biing-Ru Wu ； Lien-Cheng Hsiao ； Hung-Jen Chen ； Chih-Yu Chen ； Wei-Chih Liao ； Ping-Han Lo ； Wen-Chien Cheng ； Chih -Yen Tu ； Wu-Huei Hsu

《胸腔醫學》 35卷2期 (2020/06) Pp. 52-63

摘要

Objectives: Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) usually coexist and share the same risk factors. Early diagnosis of COPD in patients with CAD allows for early intervention, which improves the prognosis. The purpose of this study was to determine a method for early detection of COPD in this target population. Methods: In this single-center, observational, prospective study, outpatients with CAD (aged ＞40 years with a history of smoking) were evaluated. Each patient underwent a COPD assessment after coronary angiography. Data on age, smoking status, pack-year history of smoking, body mass index (BMI), and dyspnea score (Medical Research Council), and the results of a COPD assessment test (CAT) and pre- and post-bronchodilator spirometry were obtained. Results: A total of 166 patients were included in the study, most of whom were men (92.7%). A definitive diagnosis of COPD was made by spirometry in 32 patients (19.3%). Sixteen (50%) and 16 (50%) patients were assigned to group A and B respectively. Statistically significant differences in age, pack-year history of smoking, body weight, BMI, C-reactive protein (CRP) levels, serum sodium levels, and symptoms such as cough and sputum (CAT scores) were observed between CAD patients with COPD and those without COPD. Multivariate analysis revealed that aged ＞60 years (P＜0.001), a smoking history ＞30 pack-year (P=0.006), body weight ＜60 kg (P=0.04), sputum production (CAT score, Sputum ≧1) (P=0.01) and a lower serum sodium level (Na ＜135 mg/dl) (P=0.028) were independent clinical characteristics of COPD development in CAD patients. Conclusion: Approximately 19.3% of our outpatients with CAD had COPD. It is important to evaluate for COPD in CAD patients with aged ＞60 years, a history of smoking ＞30 pack-years, body weight ＜60 kg, more sputum production, and a low serum sodium level.

關鍵字

chronic obstructive pulmonary disease ； cardiovascular disease ； COPD assessment test