Coronary lesions in patients with COPD (Global Initiative for Obstructive Lung Disease stages I–III) and suspected or confirmed coronary arterial disease

Figures & data

Table 1 Demographic and clinical characteristics of patients (n = 210) with or without COPD

Variable	Total (n = 210)	COPD (n = 101)	Non-COPD (n = 109)	P-value
Age (years)a	59.6 ± 9.4	61.2 ± 9.8	58.1 ± 8.7	0.014
Male, n (%)	116 (55.2)	55 (54.5)	61 (56)	0.826
BMI (kg/m^2)a	27.6 ± 4.8	27.3 ± 5.3	28.02 ± 4.2	0.297
Comorbidities, n (%)
Hypertension	166 (79)	83 (82.2)	83 (76.1)	0.283
Diabetes mellitus	72 (34.3)	38 (37.6)	34 (31.2)	0.327
Dyslipidemia	143 (68)	73 (72.3)	70 (64.2)	0.211
Statin use	130 (61.9)	65 (64.4)	65 (59.6)	0.481
Family history of CAD	129 (61.4)	51 (50.5)	78 (71.6)	0.002
Life habits, n (%)
Alcoholism	74 (35.2)	35 (34.7)	39 (35.8)	0.864
Sedentary lifestyle	120 (57.1)	56 (55.4)	64 (58.7)	0.632
Smoking history
Current, n (%)	36 (17.1)	34 (33.7)	2 (1.8)	<0.0001
Ex-smoker, n (%)	100 (47.6)	67 (66.3)	33 (30.3)
Never smoker, n (%)	74 (35.2)	0 (0)	74 (67.9)
Pack-yearsa	17.4 ± 22.2	25.6 ± 27.7	10.9 ± 16.7	0.001
Angina, n (%)
Typical	78 (37.1)	44 (43.6)	34 (31.2)	0.101
Atypical	58 (27.6)	22 (21.8)	36 (33)
No pain	74 (35.2)	35 (34.7)	39 (35.8)
mMRC score, n (%)
0	60 (28.6)	2 (2)	58 (53.2)	<0.0001
1	94 (44.8)	51 (50.5)	43 (39.4)
2	40 (19)	32 (31.7)	8 (7.3)
3	16 (7.6)	16 (15.8)	0 (0)

Notes: CAD was evaluated by CAG or MDCT. Other variables: chi-square test or Fisher’s exact test.

a Student’s t-test for independent data.

Abbreviations: BMI, body mass index; CAD, coronary artery disease; CAG, coronary angiography; MDCT, multidetector computed tomography; mMRC, modified Medical Research Council.

Table 2 Presence, extent, and severity of CAD in patients with and without COPD, and by GOLD stages (n = 210)

Variable	COPD (n = 101)	Non-COPD (n = 109)	P-value	GOLD I (n = 41)	GOLD II (n = 47)	GOLD III (n = 13)	P-valuea
CAD, n (%)	89 (88.1)	49 (45)	<0.0001	36 (87.8)	40 (85.1)	13 (100)	<0.0001
Degree of stenosis, n (%)			<0.0001				<0.0001
Lesion ≥50%	72 (71.3)	23 (21.1)		32 (78)	27 (57.4)	13 (100)
Lesion <50%	17 (16.8)	26 (23.9)		4 (9.8)	13 (27.7)	0 (0)
Extent of CAD, n (%)			<0.0001				<0.0001
Univessel	16 (15.8)	14 (12.8)		5 (12.2)	10 (21.3)	1 (7.7)
Bivessel	19 (18.8)	14 (12.8)		10 (24.4)	6 (12.8)	3 (23.1)
Trivessel	25 (24.8)	12 (11)		12 (29.3)	10 (21.3)	3 (23.1)
Multivessel	29 (28.7)	9 (8.3)		9 (22)	14 (29.8)	6 (46.2)
LCT, n (%)	18 (17.8)	4 (3.7)	<0.0001	6 (14.6)	10 (21.3)	2 (15.4)	0.06
Severity of CAD, n (%)			<0.0001				<0.0001
Mild	10 (9.9)	16 (14.7)		2 (4.9)	8 (17)	0 (0)
Moderate	17 (16.8)	22 (20.2)		6 (14.6)	10 (21.3)	1 (7.7)
Severe	62 (61.4)	11 (10.1)		28 (68.3)	22 (46.8)	12 (92.3)

Notes: CAD was evaluated by CAG or MDCT.

a P-value referring to the comparison of the GOLD stage groups with the non-COPD group. Other variables: chi-square or Fisher’s exact test.

Abbreviations: CAD, coronary artery disease; CAG, coronary angiography; GOLD, Global Initiative for Obstructive Lung Disease; LCT, left coronary trunk; MDCT, multidetector computed tomography.

Table 3 Angiotomographic characteristics of patients with and without COPD, and by GOLD stages (n = 104)

Variable	COPD (n = 49)	Non-COPD (n = 55)	P-value	GOLD I (n = 12)	GOLD II (n = 28)	GOLD III (n = 09)	P-valuea
Type of coronary plate, n (%)			<0.0001				<0.0001
Not calcified	2 (4.1)	6 (10.9)		39 (70.9)	0 (0)	2 (7.1)
Mildly calcified	3 (6.1)	4 (7.3)		6 (10.9)	1 (8.3)	1 (3.6)
Moderately calcified	11 (22.4)	5 (9.1)		4 (7.3)	3 (25)	8 (28.6)
Severely calcified	24 (49)	1 (1.8)		5 (9.1)	4 (33.3)	13 (46.4)
Mixed	1 (2)	0 (0)		1 (1.1)	0 (0)	0 (0)
CACS, n (%)			<0.0001				<0.0001
No calcification (0)	11 (22.4)	40 (72.7)		40 (72.7)	4 (33.3)	7 (25)
Minimum (0–10)	4 (8.2)	5 (9.1)		5 (9.1)	2 (16.7)	2 (7.1)
Mild (11–100)	11 (22.4)	4 (7.3)		4 (7.3)	2 (16.7)	8 (28.6)
Moderate (101–400)	13 (26.5)	6 (10.9)		6 (10.9)	3 (25)	5 (17.9)
Severe (401–1,000)	8 (16.3)	0 (0)		0 (0)	1 (8.3)	4 (14.3)
Very severe (>1,000)	2 (4.1)	0 (0)		0 (0)	0 (0)	2 (7.1)
Percentile, n (%)			<0.0001				<0.0001
No calcification (0)	11 (22.4)	39 (70.9)		39 (70.9)	4 (33.3)	7 (25)
Minimum (0–25)	1 (2)	1 (1.8)		1 (1.8)	1 (8.3)	0 (0)
Mild (26–50)	0 (0)	3 (5.5)		3 (5.5)	0 (0)	0 (0)
Moderate (51–75)	6 (12.2)	3 (5.5)		3 (5.5)	1 (8.3)	2 (7.1)
Severe (76–90)	15 (30.6)	6 (10.9)		6 (10.9)	2 (16.7)	9 (32.1)
Very severe (>90)	16 (32.7)	3 (5.5)		3 (5.5)	4 (33.3)	10 (35.7)

a Notes: P-value referring to the comparison of the GOLD stage groups with the non-COPD group. Other variables: chi-square or Fisher’s exact test.

Abbreviations: CACS, Agatston coronary artery calcium score; GOLD, Global Initiative for Obstructive Lung Disease.

Table 4 Univariate and multivariate logistic regression with parameters associated with the presence of CAD

Parameter	Univariate analysis		Multivariate analysis
	OR (95% CI)	P-value	OR (95% CI)	P-value
COPD	9.08 (4.46–18.49)	<0.001	11.42 (5.30–24.59)	<0.001
Male	2.76 (1.53–4.97)	0.001	3.96 (1.96–7.98)	0.001
Age	1.05 (1.02–1.08)	0.002	1.03 (0.99–1.07)	0.07
Hypertension	2.06 (1.04–4.05)	0.037	2.18 (0.99–4.83)	0.54
Diabetes mellitus	1.74 (0.93–3.25)	0.083	1.65 (0.77–3.54)	0.20
Dyslipidemia	1.47 (0.80–2.68)	0.21	1.19 (0.55–2.55)	0.65
Family history	1.41 (0.77–2.55)	0.26	1.42 (0.65–3.07)	0.37

Note: This model was adjusted.

Abbreviations: CAD, coronary artery disease; CI, confidence interval; OR, odds ratio.

Table 5 Multivariate logistic regression with parameters associated with obstructive CAD (atherosclerotic lesion ≥50%)

Parameter	OR	95% CI	P-value
COPD	4.78	2.21–10.34	<0.001
Male	1.55	0.66–3.65	0.31
Age	1.04	0.99–1.09	0.07
Hypertension	0.40	0.12–1.29	0.13
Dyslipidemia	1.80	0.78–4.14	0.16

Note: This model was adjusted.

Abbreviations: CAD, coronary artery disease; CI, confidence interval; OR, odds ratio.