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Prevalence of undiagnosed COPD in male patients with coronary artery disease: a cross-sectional study in Jordan

Authors Khassawneh BY, Samrah SM, Jarrah MI, Ibdah RK, Ibnian AM, Almistarehi AW, Zghayer AA, Abuqudairi SI, Khader YS

Received 2 May 2018

Accepted for publication 29 June 2018

Published 5 September 2018 Volume 2018:13 Pages 2759—2766

DOI https://doi.org/10.2147/COPD.S172679

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell


Basheer Y Khassawneh,1 Shaher M Samrah,1 Mohamad I Jarrah,1 Rasheed K Ibdah,1 Ali M Ibnian,1 Abdelhameed W Almistarehi,1 Aseel A Zghayer,1 Saddam I Abuqudairi,1 Yousef S Khader2

1Department of Internal Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan

Purpose: COPD and coronary artery disease (CAD) are common chronic diseases with shared risk factors. COPD continues to be largely underdiagnosed and undertreated. We aimed to describe the prevalence and predictors of undiagnosed COPD in Jordanian men with CAD.
Patients and methods: In a cross-sectional study conducted at a referral center in Jordan, male patients who underwent coronary angiography for suspected CAD and reported ≥10 pack-year of cigarette smoking were recruited. Pre- and post-bronchodilator spirometry was undertaken for all participants, and COPD was defined as post-bronchodilator FEV1/FVC <70%. The finding of ≥50% coronary luminal narrowing confirmed the presence of CAD.
Results: Spirometry was undertaken for 376 men with mean age of 56.02±10.55 years, and 72.6% were active cigarettes smokers with a mean pack-year of 55.89±34.25. A CAD diagnosis was confirmed in 300 (79.8%) men. Spirometric criteria for COPD were met in 76 (15.7%) patients, of whom 91.5% were not previously diagnosed. COPD-related symptoms were common: chronic cough (44.4%), dyspnea (66.2%), and wheezes (27.9%). COPD was more common in patients with (18.0%) compared to patients without (6.6%) CAD (P=0.014). Multivariate logistic regression showed that the risk of COPD was higher in patients with CAD (OR 3.16, 95% CI, 1.10–9.09, P=0.033) and in those with chronic bronchitis (OR 13.07, 95% CI, 6.69–25.52, P<0.001).
Conclusion: There was a high prevalence of COPD among male patients with CAD and most were underdiagnosed despite having respiratory symptoms. Male smokers with CAD and respiratory symptoms should be evaluated for airflow limitation and the presence of COPD.

Keywords:
COPD, cardiovascular disease, coronary catheterization, airflow limitation, spirometry

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