The presence of cardiovascular disease is higher among patients with chronic obstructive pulmonary disease (COPD) and is associated with poor clinical outcomes. Cardiac symptoms overlap with those of COPD as do the risk factors associated with both types of organ dysfunction, namely smoking. Exacerbations of COPD are particularly important in this context, leading to an increased risk of major cardiovascular events. This increased risk may persist for as long as one year following the exacerbation event.
Because the symptoms of COPD and cardiac disease, specifically coronary artery disease overlaps, it makes the diagnosis more challenging. Coronary artery calcification has been detected in as many as 80% of patients with COPD. Unrecognized coronary artery disease is associated with and increased risk of major cardiac events. We can help reduce the risk of these events by making a strong case for early detection even in the absence of symptoms.
Understanding the factors contributing to the development of coronary artery disease and COPD is key. The shared risk factors include smoking and aging, but other biologic pathways could be important as well. The presence of vascular disease commonly called atherosclerosis is an inflammatory condition and the same pathways of inflammation may be shared by COPD exacerbations and advancing coronary artery disease.
Although coronary artery disease and COPD may share similar disease pathways the two conditions require distinct and different treatment approaches. Overlapping symptoms make diagnosis difficult and consideration of coronary artery disease in our COPD patients along with screening is warranted.
