Screening for Chronic Obstructive Pulmonary Disease in Patients with Coronary Artery Disease at a Tertiary Care Hospital

Malasree Jujjavarapu; Meenakshi Narasimhan; Sridhar Rathinam; Shahana Balasubramanian

doi:10.52756/ijerr.2024.v41spl.010

Authors

Malasree Jujjavarapu Department of Respiratory Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam-603103, Tamil Nadu, India https://orcid.org/0009-0007-4465-8815
Meenakshi Narasimhan Department of Respiratory Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam-603103, Tamil Nadu, India https://orcid.org/0000-0002-8743-149X
Sridhar Rathinam Department of Respiratory Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam-603103, Tamil Nadu, India https://orcid.org/0000-0001-7661-2351
Shahana Balasubramanian Department of Respiratory Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam-603103, Tamil Nadu, India https://orcid.org/0009-0001-8753-4413

DOI:

https://doi.org/10.52756/ijerr.2024.v41spl.010

Keywords:

COPD, CAD, Spirometry, PRISM

Abstract

Chronic Obstructive Pulmonary Disease is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious gases or particles and influenced by host factors, including abnormal lung development. COPD was the 4th most common cause of death globally, and it was anticipated to rise to the 3rd position by 2020 or sooner. Over 80% of these patients go undiagnosed. COPD and CAD frequently co-exist and interact due to various reasons like similar risk factors and pathogenesis. Although there are global studies on the prevalence of COPD in CAD patients, data from India are scarce. This study aims to find the prevalence of COPD among CAD patients and find the correlation between the occurrence of COPD and cardiac status. This study was conducted as a prospective observational cross-sectional study at Chettinad Hospital and Research Institute in India. 293 patients with angiographically proven CAD underwent pulmonary function evaluation by spirometry to assess the prevalence of COPD. Recent 2D-ECHO was also correlated. The study found that 18.77% of 293 Coronary Artery Disease (CAD) patients had COPD and 3.07% had PRISM( preserved ratio impaired spirometry, a new term coined), making it one of the few studies to report the prevalence of PRISM among CAD patients. Outside of India, studies have found that COPD prevalence ranges from 7% to 33.6% among ischemic heart disease patients. Impairment of spirometry positively correlated with the severity of CAD. Our study found a considerable frequency of missed COPD diagnoses. Hence, we recommend that when CAD is diagnosed, the initial evaluation should include a complete history of respiratory symptoms, clinical examination, and spirometry to assess pulmonary function, particularly in those who have risk factors such as smoking and the use of biomass fuel so as to identify COPD at an early stage and treat it. Identifying PRISM can help prevent its progression to COPD by making the required lifestyle modifications. A multidisciplinary approach is advised for all those diagnosed to have CAD.

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