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Undiagnosed Chronic Obstructive Pulmonary Disease In Patients Undergoing Cardiac Catheterization

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A5061 - Undiagnosed Chronic Obstructive Pulmonary Disease In Patients Undergoing Cardiac Catheterization
Author Block: A. M. Ibnian, A. W. Al-Mistarehi, A. A. Zghayer, S. I. Abuqudairi, S. M. Samrah, M. I. Jarrah, R. K. Ibdah, B. Y. Khassawneh; Department of medicine, Faculty of medicine/ Jordan university of science and technology, Irbid, Jordan.
Rationale: Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are prevalent chronic diseases with mounting morbidity and mortality. They share common risk factors including cigarettes smoking. COPD is still largely underdiagnosed and undertreated. The aim of this study is to describe prevalence of undiagnosed COPD in patients undergoing cardiac catheterization (CATH) and its relationship with CAD.
Methods: Prospectively, all patients with > 10 pack-year history of smoking who had elective CATH for suspected CAD at King Abdullah University Hospital were screened for the study. They underwent standard pre- and post-bronchodilator spirometry using handheld spirometer (FlowscreenCT; eResearch Technology GmbH, Hoechberg, Germany). COPD was diagnosed according to the GOLD criteria. Sociodemographics and clinical data were collected from the patients and their medical records. CAD was defined as ≥ 50% coronary luminal narrowing, requiring stent, or coronary artery bypass surgery (CABG).
Results: From July to October 2017, 327 patients underwent CATH and 178 (54.4%) were smokers. Majority were men 174 (97.8%) and their mean age was 56.2 years (range, 21 - 84). Most were active smokers 126 (70.8%) with an average smoking of 54.4 pack-year (range, 12-200). 142 patients were diagnosed with CAD; 116 (81.7%) treated with stent placement and 21 (14.8%) had CABG.
According to GOLD criteria 22 patients (12.4%) had COPD, the majority 18 patients (81.8%) had moderate to severe disease, Their mean FEV1% = 59.1%. Most of COPD were symptomatic and 37 (20.8%) met the classic definition of chronic bronchitis. Only 2 patients were previously diagnosed with COPD. COPD was five times more common in patients with CAD compared to patients with normal coronaries [21/142 (14.8%) vs. 1/36 (2.8%)] respectively, p = 0.036.
Conclusions: Patients with CAD are at increased risk of having COPD. Despite being symptomatic and having moderate to severe disease, patients with COPD were still undiagnosed. Health care providers should be more vigilant in diagnosing COPD in this patient population.
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