Undiagnosed airflow limitation common in CVD patients

MedWire News: Airflow limitation is common but underdiagnosed in patients with cardiovascular disease (CVD), researchers have found.

Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD) and a significant contributor to the development of CVD, explain Joan Soriano (Recinte Hospital Joan March, Bunyola, Spain) and team in the journal Chest.

However, they add: “The prevalence of airflow limitation (AL) in patients with CVD is unknown, and whether AL is adequately diagnosed and treated in these patients has not been investigated before, to our knowledge.”

To address this, the researchers studied 450 individuals with and 52 without CVD who participated in the population-based COR Sà Illes Balears (CORSAIB) study, as well as 119 hospital patients with coronary artery disease (CAD).

All the participants underwent spirometry lung function tests. AL suggestive of COPD was defined according to the Global Initiative for Obstructive Lung Disease guidelines as a postbronchodilator FEV1/forced vital capacity (FVC) ratio of less than 0.7.

Analysis of spirometry results revealed that hospital patients with CAD had the greatest prevalence of AL, at 33.6%. The prevalence of AL in CORSAIB participants with and without CVD was 19.2% and 17.5%, respectively.

Of the hospital patients with CAD, 47.5% had mild AL, 42.5% moderate AL, and 10.0% severe AL. In CORSAIB participants with CVD, 30.0% had mild, 50.0% moderate, and 20.0% severe AL, and in CORSAIB participants without CVD, these percentages were, respectively, 48.8%, 43.8%, and 6.3%.

Despite the high prevalence of AL in the participants, 87.2% of hospital patients with CAD, 60.0% of CORSAIB participants with CVD, and 81.0% of CORSAIB participants without CVD who had evidence of AL had not been diagnosed with the condition.

Consequently, a total of 60.0% of patients with spirometrically confirmed AL had not received any respiratory treatment for the condition.

Soriano and team conclude: “Our results show that the prevalence of AL in patients with CVD is substantial, that most of these patients are not diagnosed appropriately, and that the majority of them are not treated whatsoever.”

They add: “Given that COPD is a preventable and treatable disease, this unfortunate clinical situation should be corrected promptly. We therefore propose here that screening of AL/COPD by forced spirometry must be considered routinely in the clinical management of smokers or former smokers with CVD.”

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