0
Correspondence |

COPD and Ischemic Heart DiseaseCOPD and Ischemic Heart Disease FREE TO VIEW

Pedro Almagro, MD; Carlos Fernandez, MD; Jose L. Heredia, MD
Author and Funding Information

From Internal Medicine (Dr Almagro), Cardiology Unit (Dr Fernandez), and Pneumology Unit (Dr Heredia), Hospital Mutua de Terrassa.

Correspondence to: Pedro Almagro, MD, Hospital Mutua de Terrassa–Internal Medicine, Pza Dr Robert 5, Terrassa, Barcelona, 08221, Spain; e-mail: palmagro@mutuaterrassa.es


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(2):571-572. doi:10.1378/chest.11-2414
Text Size: A A A
Published online

To the Editor:

We read with interest the article by Enriquez and colleagues1 in a recent issue of CHEST (September 2011) about the increased number of adverse events after percutaneous coronary intervention (PCI) in patients with COPD. Data from their study are consistent with those reported previously, indicating a higher incidence of adverse effects and mortality in patients with a previous diagnosis of COPD undergoing coronary catheterization for ischemic heart disease.2 However, diagnosis of COPD in both was based upon clinical criteria plus questionable criteria (COPD medication or a pre-bronchodilator (BD) FEV1 <75% predicted value) without full respiratory functional studies, while in the Konecny et al3 study, spirometry was available only in 60% of patients. In our opinion, this explains the observed low prevalence of COPD (Berger et al,2 4%; Enriquez et al,1 8%; and Konecny et al,3 13%), which is clearly lower than expected in this population (even in the general adult population). In contrast, the prevalence observed by Soriano et al4 in patients with ischemic heart disease confirmed by PCI and with full post-BD spirometry was 34% and, of note, with an underdiagnosis of 87%.1 Similarly, in a prospective study currently underway at our institution, spirometry within the prevalence of COPD was 20% in the first 72 patients with ischemic heart disease confirmed by PCI and with full post-BD, with an underdiagnosis of 72% (unpublished data, 2012). It seems plausible that the lack of a more accurate diagnosis can modify the results by Enriquez and colleagues1 to classifying as patients with COPD only those with more symptomatic and perhaps more severe disease. Given all prognostic and therapeutics implications, it should be advisable to conduct spirometry in patients with ischemic heart disease referred for PCI.

Enriquez JR, Parikh SV, Selzer F, et al. Increased adverse events after percutaneous coronary intervention in patients with COPD: insights from the National Heart, Lung, and Blood Institute dynamic registry. Chest. 2011;1403:604-610 [PubMed] [CrossRef]
 
Berger JS, Sanborn TA, Sherman W, Brown DL. Effect of chronic obstructive pulmonary disease on survival of patients with coronary heart disease having percutaneous coronary intervention. Am J Cardiol. 2004;945:649-651 [PubMed]
 
Konecny T, Somers K, Orban M, et al. Interactions between COPD and outcomes after percutaneous coronary intervention. Chest. 2010;1383:621-627 [PubMed]
 
Soriano JB, Rigo F, Guerrero D, et al. High prevalence of undiagnosed airflow limitation in patients with cardiovascular disease. Chest. 2010;1372:333-340 [PubMed]
 

Figures

Tables

References

Enriquez JR, Parikh SV, Selzer F, et al. Increased adverse events after percutaneous coronary intervention in patients with COPD: insights from the National Heart, Lung, and Blood Institute dynamic registry. Chest. 2011;1403:604-610 [PubMed] [CrossRef]
 
Berger JS, Sanborn TA, Sherman W, Brown DL. Effect of chronic obstructive pulmonary disease on survival of patients with coronary heart disease having percutaneous coronary intervention. Am J Cardiol. 2004;945:649-651 [PubMed]
 
Konecny T, Somers K, Orban M, et al. Interactions between COPD and outcomes after percutaneous coronary intervention. Chest. 2010;1383:621-627 [PubMed]
 
Soriano JB, Rigo F, Guerrero D, et al. High prevalence of undiagnosed airflow limitation in patients with cardiovascular disease. Chest. 2010;1372:333-340 [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543