Korean J Intern Med.  2012 Jun;27(2):189-196. 10.3904/kjim.2012.27.2.189.

Prognosis in Patients Having Chronic Obstructive Pulmonary Disease with Significant Coronary Artery Lesion Angina

• Park TY
• Kim KH
• Koo HK
• Lee JY
• Lee SM
• Yim JJ
• Yoo CG
• Kim YW
• Han SK
• Yang SC

• KMID: 1776546
• DOI: http://doi.org/10.3904/kjim.2012.27.2.189

Abstract

BACKGROUND/AIMS
Many studies have investigated angina and its relationship with chronic obstructive pulmonary disease (COPD). However, angina was diagnosed only by noninvasive tests or only by clinical symptoms in most of these studies. The aim of this study was to compare the prognosis, including rate of hospitalization and death from significant coronary artery lesion and nonsignificant coronary artery lesion angina, in patients with COPD.
METHODS
Patients with COPD who underwent coronary angiography (CAG) due to angina were reviewed retrospectively at a tertiary referral hospital. COPD is defined as post-bronchodilator forced expiratory volume in 1 sec/forced vital capacity (FEV1/FVC) of < 70%. A significant coronary lesion is defined as at least 50% diameter stenosis of one major epicardial artery in CAG.
RESULTS
In total, 113 patients were enrolled. Mean follow-up duration was 39 +/- 21 months. Of the patients, 52 (46%) had mild COPD and 48 (42%) had moderate COPD. Sixty-nine (61%) patients had significant stenosis in CAG. The death rate in the follow-up period was 2.21 per 100 patient-years. No significant difference was observed among the all-cause mortality rate, admission rate, or intensive care unit admission rate in patients who had COPD with or without significant coronary artery disease. Pneumonia or acute exacerbation of COPD was the most common cause of admission.
CONCLUSIONS
In patients having COPD with angina who underwent CAG, no significant difference was observed in mortality or admission events depending on the presence of a significant coronary artery lesion during the 2-year follow-up period.

Keyword

Pulmonary disease, chronic obstructive; Coronary angiography; Coronary stenosis

MeSH Terms

Aged
Angina Pectoris/*etiology
Chi-Square Distribution
Coronary Angiography
Coronary Stenosis/*complications/mortality/radiography
Female
Forced Expiratory Volume
Hospitalization
Humans
Kaplan-Meier Estimate
Lung/physiopathology
Male
Middle Aged
Prognosis
Pulmonary Disease, Chronic Obstructive/*complications/diagnosis/mortality/physiopathology
Republic of Korea
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Spirometry
Time Factors
Vital Capacity