Cardiovascular Prognosis of Subclinical Chronic Obstructive Pulmonary Disease in Patients with Suspected or Confirmed Coronary Artery Disease

Figures & data

Table 1 Demographic and Clinical Characteristics of Patients with and without COPD

Variable	Total (n = 117)	COPD (n = 44)	Non-COPD (n = 73)	p-value*
Age (years)	59 ± 10	62 ± 9	58 ± 10	0.028
Male, n (%)	63 (53.8)	26 (59.1)	37 (50.7)	0.377
BMI (kg/m²)	27.82 ± 4.66	27.96 ± 4.89	27.74 ± 4.56	0.930
Cardiovascular risk factors, n (%)
Hypertension	93 (79.5)	38 (86.4)	55 (75.3)	0.153
Dyslipidemia	78 (66.7)	32 (72.37)	46 (63.0)	0.280
Diabetes mellitus	41 (35.0)	21 (47.7)	20 (27.4)	0.026
Family history of CAD	75 (64.1)	26 (59.1)	49 (67.1)	0.380
Life habits, n (%)
Current smoking	16 (13.7)	14 (31.8)	02 (2.7)	< 0.001
Sedentary lifestyle	66 (56.4)	23 (52.3)	43 (58.9)	0.483
Alcoholism	39 (33.3)	16 (36.4)	23 (31.5)	0.589
Angina, n (%)
Typical	44 (37.6)	18 (40.9)	26 (35.6)	0.550
Atypical	33 (28.2)	09 (20.5)	24 (32.9)	0.160
mMRC score, n (%)				< 0.001
0	37 (33.0)	00 (00.0)	37 (54.4)	–
1	46 (41.1)	21 (47.7)	25 (36.8)	–
2	20 (17.9)	14 (31.8)	06 (8.80)	–
3	09 (8.00)	09 (20.5)	00 (00.0)	–
Spirometric data
VEF1(L)	–	1.86 ± 0.59	2.62 ± 0.58	< 0.001
VEF1 predicted (%)	–	69.80 ± 16.76	90.85 ± 9.97	< 0.001
FVC (L)	–	2.89 ± 0.78	3.17 ± 0.76	0.053
FVC predicted (%)	–	86.37 ± 12.30	89.10 ± 9.10	0.169
VEF1/ FVC ratio (%)	–	63.20 ± 6.89	83.47 ± 7.04	< 0.001

Notes: *p-value referring to the comparison of COPD with the non-COPD group; Student’s t-test, chi-square test or Fisher’s exact test was used for statistical analyses, as appropriate.

Abbreviations: COPD, chronic obstructive pulmonary disease; BMI, body mass index; CAD, coronary artery disease; mMRC, modified medical research council; VEF1, forced expiratory volume in one second; FVC, forced vital capacity.

Table 2 Presence, Extent and Severity of CAD in Patients with and without COPD

Variable	Total (n = 117)	COPD (n = 44)	Non-COPD (n = 73)	p-value*	W-Cohen^§
CAD^†, n (%)	69 (59.0)	40 (90.9)	29 (39.7)	< 0.001	0.825
Degree of luminal stenosis, n (%)
Lesion < 50%	27 (23.1)	11 (25.0)	16 (21.9)	0.620	–
Lesion ≥ 50%	42 (35.9)	29 (65.7)	13 (17.8)	< 0.001	0.786
Severity of CAD, n (%)
Mild	17 (14.5)	7 (15.9)	10 (13.7)	0.550	–
Moderate	20 (17.1)	9 (20.5)	11 (15.1)	0.620	–
Severe	32 (27.4)	24 (54.5)	8 (11.0)	< 0.001	0.761
Extent of CAD, n (%)
Univessel	18 (15.4)	8 (18.2)	10 (13.7)	0.230	–
Bivessel	16 (13.7)	10 (22.7)	6 (8.2)	0.050	–
Trivessel	22 (18.8)	14 (31.8)	8 (11.0)	0.010	0.379
LMCA + 03 vessels	13 (11.1)	8 (18.2)	5 (6.8)	0.090	–

Notes: *p-value referring to the comparison of COPD with the non-COPD group; ^§adjusted for table size; ^†CAD was evaluated by CCTA or invasive coronary angiography; chi-square test or Fisher’s exact test was used for statistical analyses, as appropriate.

Abbreviations: COPD, chronic obstructive pulmonary disease; CAD, coronary artery disease; CCTA, coronary computed tomography angiography; LMCA, left main coronary artery.

Table 3 Adverse Cardiovascular Events at Six-Years Follow-Up in Patients with and without COPD

Adverse Cardiovascular Events	Total (n = 117)	COPD (n = 44)	Non-COPD (n = 73)	p-value*	W-Cohen^§
Composite cardiovascular events, n (%)	31 (26.5)	23 (52.3)	8 (11.0)	< 0.001	0.720
Coronary angiography, n (%)	23 (19.7)	16 (36.4)	7 (9.6)	< 0.001	0.488
Cardiac revascularization^†, n (%)	15 (12.8)	11 (25.0)	4 (5.5)	0.002	0.417
Myocardial Infarction, n (%)	17 (14.5)	12 (27.3)	5 (6.8)	0.002	0.414
Cardiac hospitalization, n (%)	18 (15.4)	12 (27.3)	6 (8.2)	0.019	0.374
Cardiac death, n (%)	1 (0.9)	1 (2.3)	0 (0)	0.185	–

Notes: *p-value referring to the comparison of COPD with the non-COPD group; ^§adjusted for table size; ^†cardiac revascularization by PCI or bypass surgery; chi-square test or Fisher’s exact test was used for statistical analyses, as appropriate.

Abbreviations: COPD, chronic obstructive pulmonary disease; PCI, percutaneous coronary intervention.

Figure 1 Kaplan Meier curves of survival free of adverse cardiovascular events in COPD patients and non-COPD patients during six-year follow-up (p < 0.001).

Table 4 Adverse Cardiovascular Events at Follow-Up of COPD Patients According GOLD Class

Variable	Total (n = 44)	GOLD I (n = 15)	GOLD II and III (n = 29)	p-value*
Composite cardiovascular events, n (%)	23 (52.3)	6 (40)	17 (58.6)	0.241
Coronary angiography, n (%)	16 (36.4)	5 (33.3)	11 (37.9)	0.764
Cardiac revascularization^†, n (%)	11 (25.0)	2 (13.3)	9 (31.0)	0.199
Myocardial Infarction, n (%)	12 (27.3)	3 (20)	9 (31)	0.436
Cardiac hospitalization, n (%)	12 (27.3)	2 (13.3)	10 (34.5)	0.225
Cardiac death, n (%)	1 (2.3)	1 (6.7)	0 (0)	0.292

Notes: *p-value referring to the comparison within the GOLD stage groups; ^†cardiac revascularization by PCI or bypass surgery; chi-square test or Fisher’s exact test was used for statistical analyses, as appropriate.

Abbreviations: COPD, chronic obstructive pulmonary disease; GOLD, global initiative for obstructive lung disease; PCI, percutaneous coronary intervention.