Prevalence and Clinical Correlates of Radiologically Detected Coronary Artery Disease in Chronic Obstructive Pulmonary Disease: A Cross-Sectional Observational Study
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Le résumé fourni par la source
Abstract Rationale Unrecognized coronary artery disease (CAD) may contribute to adverse outcomes in chronic obstructive pulmonary disease (COPD). Improved identification of at-risk groups could inform better preventive care. Objectives We aimed to evaluate the burden and relationships of radiologically detectable CAD in COPD, establish the frequency of occult disease, and examine potential cardiovascular screening methods. Methods Using computed tomography (CT) coronary angiography, we prospectively evaluated CAD in 50 patients with COPD compared with age- and sex-matched controls. In those with COPD, the relationship of CAD to cardiac symptoms (chest pain, dyspnea), functional capacity (6-minute-walk distance), exacerbations, and inflammation was assessed. The performance of screening tests (cardiovascular risk scores, biomarkers, and thoracic CT–derived coronary artery calcium score) were evaluated using receiver operating characteristic curves. Measurements and Main Results CAD was present in 88% of patients with COPD (42% had obstructive [⩾50% stenosis of any vessel] and 28% severely obstructive [⩾70%] disease). Rates of obstructive (OR, 3.1; 95% CI, 1.1–8.9; P = 0.037) and severely obstructive CAD (OR, 10.1; 95% CI, 1.9–52.7; P = 0.006) were higher in those with COPD than in controls. In the COPD group, those with CAD had greater functional impairments but not greater dyspnea scores, and 75% reported no chest pain or prior ischemic heart disease. CAD was more extensive in those with increased systemic inflammation (fibrinogen, C-reactive protein, and leukocyte and neutrophil counts), bronchial wall thickening, and sputum bacterial growth but bore no relation to exacerbation frequency. The thoracic CT–derived coronary artery calcium score was an effective screening tool, with areas under the curve of 0.98 (95% CI, 0.95–1.00) for CAD and 0.89 (95% CI, 0.79–1.00) for obstructive CAD. Conclusions CT coronary angiography–detected CAD is common in patients with COPD but correlates poorly with symptoms and conventional risk scores. Radiological screening with standard (non ECG-gated) CT of the thorax might improve detection and outcome in this patient group.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Prevalence and Clinical Correlates of Radiologically Detected Coronary Artery Disease in Chronic Obstructive Pulmonary Disease: A Cross-Sectional Observational Study
- Date Crossref
- 01/06/2025
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Imperial College London National Heart and Lung Institute pays non établi dans la noticeUniversité ou école supérieure
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University of Ulster pays non établi dans la noticeUniversité ou école supérieure
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Harefield Hospital pays non établi dans la noticeÉtablissement de santé
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Royal Victoria Hospital pays non établi dans la noticeÉtablissement de santé
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St Thomas' Hospital pays non établi dans la noticeÉtablissement de santé
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Chelsea and Westminster Hospital NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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AstraZeneca (United Kingdom) pays non établi dans la noticeEntreprise
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AstraZeneca (Singapore) pays non établi dans la noticeEntreprise
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AstraZeneca (Spain) pays non établi dans la noticeEntreprise
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Chelsea and Westminster National Health Service Foundation Trust pays non établi dans la noticeOrganisation à but non lucratif
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Early Respiratory & Immunology Clinical Development pays non établi dans la noticeÉtablissement de santé
National Heart and Lung Institute — Imperial College London, University of Ulster et Harefield Hospital, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.