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The Complex Relationship Between Ischemic Heart Disease and COPD ExacerbationsIschemic Heart Disease and COPD Exacerbations

Jonathan P. Man, MD; Donald D. Sin, MD, FCCP; Andrew Ignaszewski, MD; S. F. Paul Man, MD, FCCP; American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure)
Author and Funding Information

From the Respirology Division (Drs Sin and S. Man), and the Cardiology Division (Dr Ignazsewski), the University of British Columbia; and the University of Pennsylvania School of Medicine (Dr J. Man).

Correspondence to: S. F. Paul Man, MD, FCCP, Department of Medicine, St. Paul’s Hospital, #548 Burrard Bldg, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada; e-mail: pman@providencehealth.bc.ca


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(4):837-838. doi:10.1378/chest.11-2483
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COPD and ischemic heart disease (IHD) are two leading reasons for hospitalization and mortalities in North America.1,2 Together, they are responsible for >60% of all smoking-related fatalities.3 IHD and COPD often coexist. More than one-third of patients with angiography-proven IHD also have COPD on spirometry.4 This tight relationship between COPD and IHD is beyond a shared risk factor (cigarette smoking); there is growing evidence that COPD and IHD share mechanistic pathways, including accelerated aging, oxidative stress, and inflammation. For instance, a study has suggested that cell senescence (shortened telomere length as a surrogate biomarker) is found in patients with IHD,5 and similarly, early senescence may contribute to the development of emphysema.6 Lung inflammation is an intrinsic component in the pathogenesis of COPD leading to systemic inflammation, which contributes to atherosclerosis and IHD.7

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