Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
J Korean Med Sci. 2023 Oct 30;38(42):e344. doi: 10.3346/jkms.2023.38.e344.
Subjects with chronic obstructive pulmonary disease (COPD) have a higher risk of ischemic heart disease (IHD) than individuals without COPD; however, longitudinal evidence is lacking. Therefore, we aimed to estimate the risk of IHD between COPD and control cohorts using a longitudinal nationwide database.
We used 2009-2017 data from the Korean National Health Insurance Service National Sample Cohort (NHIS-NSC). Adult participants at least 20 years of age who underwent health examinations and without a history of COPD or IHD were included (n = 540,976). Participants were followed from January 1, 2009, until death, development of IHD, or December 31, 2019, whichever came first.
At baseline, there were 3,421 participants with incident COPD and 537,555 participants without COPD. During a median of 8.0 years (5.3-9.1 years) of follow-up, 2.51% of the participants with COPD (n = 86) and 0.77% of the participants without COPD (n = 4,128) developed IHD, with an incidence of 52.24 and 10.91 per 10,000 person-years, respectively. Participants with COPD had a higher risk of IHD (adjusted hazard ratio, 1.55; 95% confidence interval, 1.25-1.93) than subjects without COPD. Demographics such as age, sex, body mass index, and personal health behaviors including smoking status and physical activity did not show significant interaction with the relationship between COPD and IHD ( for interaction > 0.05 for all).
The results indicate that COPD is associated with the development of IHD independent of demographic characteristics and health-related behaviors. Based on these results, clinicians should closely monitor the onset of IHD in subjects with COPD.
患有慢性阻塞性肺疾病（COPD）的患者发生缺血性心脏病（IHD）的风险高于无 COPD 的个体；然而，目前缺乏纵向证据。因此，我们旨在使用纵向全国性数据库评估 COPD 和对照组之间发生 IHD 的风险。
我们使用了 2009 年至 2017 年来自韩国国民健康保险服务国家样本队列（NHIS-NSC）的数据。纳入至少 20 岁且既往无 COPD 或 IHD 病史的成年参与者（n=540976）。参与者从 2009 年 1 月 1 日开始随访，直至死亡、发生 IHD 或 2019 年 12 月 31 日，以先发生者为准。
在基线时，有 3421 名参与者患有新发 COPD，537555 名参与者无 COPD。在中位数为 8.0 年（5.3-9.1 年）的随访期间，有 2.51%的 COPD 参与者（n=86）和 0.77%的无 COPD 参与者（n=4128）发生了 IHD，发病率分别为 52.24 和 10.91/10000 人年。与无 COPD 者相比，COPD 患者发生 IHD 的风险更高（调整后的危险比，1.55；95%置信区间，1.25-1.93）。年龄、性别、体重指数和个人健康行为（包括吸烟状况和身体活动）等人口统计学因素与 COPD 和 IHD 之间的关系没有显著交互作用（所有交互作用>0.05）。
这些结果表明，COPD 与 IHD 的发生有关，与人口统计学特征和与健康相关的行为无关。基于这些结果，临床医生应密切监测 COPD 患者 IHD 的发病情况。
