University Tunis El Manar. Faculty of Medicine of Tunis. Street Djebel Lakhdhar. La Rabta. 2007. Tunis. Tunisia; Department of Pneumology. Interior Security Forces Hospital. Street Taher Ben Achour. La Marsa. 2070. Tunis. Tunisia.
University Tunis El Manar. Faculty of Medicine of Tunis. Street Djebel Lakhdhar. La Rabta. 2007. Tunis. Tunisia; Department of Pneumology. Interior Security Forces Hospital. Street Taher Ben Achour. La Marsa. 2070. Tunis. Tunisia.
Respir Med. 2021 Apr;179:106335. doi: 10.1016/j.rmed.2021.106335. Epub 2021 Feb 16.
Chronic obstructive pulmonary disease (COPD) and ischemic heart disease (IHD) are common causes of mortality worldwide, with shared risk factors. COPD continues to be largely underdiagnosed and undertreated, especially in patients with IHD.
To investigate the prevalence of COPD in smokers with confirmed IHD and to compare IHD characteristics between COPD patients and those without COPD.
It was a cross-sectional study, conducted between August and December 2017, including patients over 40 years of age, current or former smokers, with stable and confirmed IHD. Spirometry was undertaken for all participants, and COPD was defined according to GOLD criteria.
A total of 122 patients, with mean age of 59.3 years and mean pack-year of 52.3, were enrolled. Spirometry was normal in 63.2% of patients and airflow limitation was the most frequent ventilatory disorder (20.5%). COPD was diagnosed in 19.7% of patients. Of the 24 COPD patients, 17 (70.8%) were previously undiagnosed. Airflow limitation severity in COPD patients was classified mild, moderate, severe and very severe in 25%, 62.5%, 8.3% and 4.2% of patients. Comparison between COPD patients and non-COPD patients showed that comorbidities, respiratory symptoms, chest x-ray abnormalities, life-threatening lesions, three vessel disease, pulmonary hypertension and right ventricle dysfunction were significantly more frequent in COPD patients.
There was a high prevalence of COPD among smoking patients with IHD, and most were undiagnosed despite being symptomatic. Smokers with IHD, especially if having respiratory symptoms, radiological or ultrasound abnormalities or life-threatening coronary lesions should be evaluated for airflow limitation.
慢性阻塞性肺疾病（COPD）和缺血性心脏病（IHD）是全球常见的死亡原因，具有共同的危险因素。COPD 仍然在很大程度上被漏诊和治疗不足，尤其是在合并 IHD 的患者中。
调查已确诊 IHD 的吸烟者中 COPD 的患病率，并比较 COPD 患者和非 COPD 患者的 IHD 特征。
这是一项横断面研究，于 2017 年 8 月至 12 月进行，纳入年龄在 40 岁以上、目前或曾经吸烟、稳定且确诊为 IHD 的患者。所有参与者均进行了肺量测定，COPD 根据 GOLD 标准定义。
共纳入 122 名患者，平均年龄 59.3 岁，平均吸烟年数为 52.3 年。63.2%的患者肺量测定正常，最常见的通气障碍是气流受限（20.5%）。19.7%的患者诊断为 COPD。在 24 名 COPD 患者中，有 17 名（70.8%）之前未被诊断。24 名 COPD 患者中，气流受限严重程度分类为轻度、中度、重度和极重度的患者分别占 25%、62.5%、8.3%和 4.2%。COPD 患者与非 COPD 患者的比较显示，合并症、呼吸症状、胸部 X 线异常、危及生命的病变、三支血管病变、肺动脉高压和右心室功能障碍在 COPD 患者中更为常见。
在合并 IHD 的吸烟患者中，COPD 的患病率很高，尽管有症状，但大多数患者仍未被诊断。合并 IHD 的吸烟者，特别是有呼吸症状、影像学或超声异常或危及生命的冠状动脉病变的吸烟者，应评估气流受限。
