Atherosclerotic coronary lesions in patients with chronic obstructive pulmonary disease

Scope: Coronary artery disease (CAD) and chronic ob-structive pulmonary disease (COPD) share several risk factors, such as smoking, sedentary lifestyles, aging. Patients with airway limitation are at increased risk of mortality for acute cardiovascular events, so COPD could be an independent risk factor for cardiovascular morbidity. Recent research has shown a frequent asso-ciation between CAD and bronchial obstruction, with less data being reported on the extent of coronary athe-rosclerotic lesions.

Methods: The clinical study was performed on a group of 52 patients (mean age 63.38 ± 3.42 years), of whom 40 (76.92%) were men with COPD GOLD II-IV for exacerbation in Saint Trinity hospital. Coronary athe-rosclerotic damage was assessed by coronary angiogra-phy at the preceding steps. The patients were clinically and paraclinically investigated according to the Euro-pean guidelines.

Results: T he analysis of cardiovascular risk factors showed that most patients had increased body mass index, namely 25 (48.08%) – overweight, 18 (34.61%) first degree obesity, 10 (19.23%) grade II obesity, and 7 (13.46%) patients had grade III obesity. Smokers (ex-smokers) of them were 42 (80.76%) patients, most of them male 39 (92.86%). Type II diabetes was also com-monly found in 19 (36.54%) patients. Blood hyperten-sion was diagnosed in 29 (55.77%) patients. Functio-nal II-III angina pectoris was present in 46 (88.46%) of cases, old myocardial infarction – in 32 (61.15%) of cases, and in 6 (11.54%) of cases – repeated myocardi-al infarction. Analysis of coronary angiography results found that only 3 (5.77%) clinical cases lacked signi-ficant hemodynamic atherosclerotic lesions, while the other 49 (94.23%) patients had obstructive coronary heart disease with a stenosis degree exceeding 75%. In 8 (16.33%) of cases monovascular coronary invol-vement was diagnosed, in 10 (20.41%) – bi-vessel and in the other 63 (69.39%) – three-vessel coronary artery disease. Interpretation of the angiographic data did not reveal gender-specific features. In the reference peri-od, 41 (78.84%) of the total of 52 follow-up patients benefited from revascularization interventions, inclu-ding coronary angioplasty and stent implantation – in 33 (63.46%) and aorto-coronary bypass in another 8 (15.38%) persons, respectively (p<0.01).

Conclusions: Coronary patients with coexisting chro-nic obstructive pulmonary disease are required by a complex multidisciplinary approach to prevent acute cardiopulmonary events and reduce premature morta-lity.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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