Elsevier

Respiratory Medicine

Volume 104, Issue 7, July 2010, Pages 1035-1041
Respiratory Medicine

Prevalence and impact of coronary artery disease in idiopathic pulmonary fibrosis

https://doi.org/10.1016/j.rmed.2010.02.008Get rights and content
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Summary

Introduction

Idiopathic Pulmonary Fibrosis (IPF) is a progressive disease with a poor prognosis for which there is no effective medical therapy. An awareness of comorbidities that are treatable and might impact outcomes in these patients is therefore very important. We sought to determine the prevalence of coronary artery disease (CAD) in IPF patients in comparison to a control group of patients with chronic obstructive pulmonary disease (COPD). We also sought to assess the impact of CAD on IPF patient outcomes.

Patients and methods

IPF and COPD transplant candidates whose work-up included left heart catheterization were categorized as having significant CAD, non-significant CAD or no disease. The risk factor profile and prevalence of CAD in both groups was compared.

Results

There were 73 IPF and 56 COPD patients. The prevalence of CAD was 65.8% in the IPF group compared to 46.1% in the COPD patients (p < 0.028). Significant disease was present in 28.8% of IPF patients vs.16.1% of the COPD patients (p < 0.081). Unsuspected significant CAD was found in 18% of IPF patients versus 10.9% of COPD patients (p < 0.004). Outcomes of IPF patients with significant CAD was worse than those with no or non-significant disease (p < 0.003) with a median survival of 572 days from the time of left heart catheterization.

Conclusion

There is a higher prevalence of CAD in IPF patients compared to a similarly matched COPD group. This increased association appeared to be independent of common coronary artery risk factors. IPF patients with significant CAD appear to have worse outcomes.

Keywords

Pulmonary fibrosis
Coronary artery disease
Pulmonary disease
Chronic obstructive
Heart catheterization

Abbreviations

CAD
coronary artery disease
CI
confidence interval
COPD
chronic obstructive pulmonary disease
IPF
idiopathic pulmonary fibrosis
LHC
left heart catheterization

Cited by (0)

This study was unfunded. None of the authors have any financial conflicts of interest relevant to the subject of this manuscript.