Is coronary heart disease on CT associated with early development of COPD?
Patients who suffer from chronic obstructive pulmonary disease have higher odds of also being diagnosed with coronary heart disease, regardless of COPD severity, according to a new study.
“COPD and coronary heart disease (CHD) frequently co-occur, yet which COPD phenotypes are most prone to CHD is poorly understood,” explained correspond author Christina Due Svendsen, of the Department of Thoracic Medicine at Haukeland University Hospital in Bergen, Norway, and co-authors.
Researchers sought to assess the level of CHD risk to patients with COPD, as well as what other factors might influence said risk. To achieve this, they recruited two cohorts of patients—347 with COPD and 428 non-COPD, healthy control patients. Participants underwent a slew of exams, including computed tomography angiography (CCTA), pulmonary CT and other lung function tests.
In both groups, CHD was noted—12.6% in the COPD group and 5.7% in the control group. Coronary stenosis and calcium scores (CaSc) were higher in a bigger portion of the COPD group than in the controls, at 55.9% compared to 31.6%. These findings were derived after adjusting for factors such as sex, age, body composition, smoking habits, cholesterol/blood pressure lowering medication use and diabetes mellitus.
Interestingly, the authors noted that none of these factors were found to be significantly associated with the higher instances of CHD in COPD patients. Likewise, COPD disease severity as measured by lung function, exacerbation risk, emphysema, etc., was not indicative of presence of either coronary stenosis or CaSc>100.
That led the authors to suggest the CHD risk could be an effect that could be identified during the early development of COPD and should be screened for accordingly.
"This study shows the importance of early detection of coronary heart disease among COPD patients, especially considering the overlapping symptoms,” the authors wrote. “Clinicians need to keep in mind that having COPD, regardless of disease severity, carries with it an increased risk of CHD. This awareness is important to avoid oversight of symptoms like dyspnea and vague chest discomfort, which can easily be interpreted as symptoms caused by the known disease COPD.”
The full research can be viewed in PLoS ONE.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.