Coronary artery disease concomitant with chronic obstructive pulmonary disease
Article first published online: 26 OCT 2013
© 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd
European Journal of Clinical Investigation
Volume 44, Issue 1, pages 93–102, January 2014
How to Cite
Eur J Clin Invest 2014; 44 (1): 93–102
- Issue published online: 18 DEC 2013
- Article first published online: 26 OCT 2013
- Accepted manuscript online: 25 SEP 2013 07:40AM EST
- Manuscript Accepted: 19 SEP 2013
- Manuscript Received: 5 AUG 2013
- Chiesi Foundation and the Italian Ministry of Health
- chronic bronchitis;
- ischaemic heart disease;
- respiratory system;
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.
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.
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.
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.