Coronary artery disease concomitant with chronic obstructive pulmonary disease

Authors

  • Sara Roversi,

    1. Section of Cardiology, Department of Medicine and Emergency Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
    Search for more papers by this author
  • Pietro Roversi,

    1. Section of Respiratory Diseases, Department of Oncology Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
    Search for more papers by this author
  • Giuseppe Spadafora,

    1. Section of Cardiology, Department of Medicine and Emergency Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
    Search for more papers by this author
  • Rosario Rossi,

    1. Section of Cardiology, Department of Medicine and Emergency Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
    Search for more papers by this author
  • Leonardo M. Fabbri

    Corresponding author
    1. Section of Respiratory Diseases, Department of Oncology Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
    • Correspondence to: Leonardo M. Fabbri, Department of Oncology Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Policlinico di Modena, Largo del Pozzo 71, 44124 Modena, Italy. Tel.: +39 059 4222198; fax +39 059 4224231; e-mail: leonardo.fabbri@unimore.it

    Search for more papers by this author

Abstract

Background

Numerous epidemiologic studies have linked the presence of chronic obstructive pulmonary disease (COPD) to coronary artery disease (CAD). However, prevalence, pathological processes, clinical manifestations and therapy are still debated, as progress towards uncovering the link between these two disorders has been hindered by the complex nature of multimorbidity.

Methods

Articles targeting CAD in patients with COPD were identified from the searches of MEDLINE and EMBASE databases in July 2013. Three authors reviewed available evidence, focusing on the latest development on disease prevalence, pathogenesis, clinical manifestations and therapeutic strategies. Both clinical trial and previous reviews have been included in this work.

Results

The most accredited hypothesis asserts that the main common risk factors, that is, cigarette smoke and ageing, elicit a chronic low-grade systemic inflammatory response, which affects both cardiovascular endothelial cells and airways/lung parenchyma. The development of CAD in patients with COPD potentiates the morbidity of COPD, leading to increased hospitalizations, mortality and health costs. Moreover, correct diagnosis is challenging and therapies are not clearly defined.

Conclusions

Evidence from recently published articles highlights the importance of multimorbidity in patient management and future research. Moreover, many authors emphasize the importance of low-grade systemic inflammation as a common pathological mechanism and a possible future therapeutic target.

Ancillary