Prevalence and impact of coronary artery disease in idiopathic pulmonary fibrosis

Nathan, Steven D.; Basavaraj, Ashwin; Reichner, Cristina; Shlobin, Oksana A.; Ahmad, Shahzad; Kiernan, Joseph; Burton, Nelson A.; Barnett, Scott D.

doi:10.1016/j.rmed.2010.02.008

Cited by 163 publications

(117 citation statements)

References 21 publications

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“…25 A recent study of 73 IPF and 56 COPD patients found the prevalence of coronary artery disease was higher in those with IPF (65.8% vs. 46.1%), with more severe disease also being more common in those with IPF. 5 People with IPF who have severe coronary artery disease also appear to have worse outcomes. 5 Using UK primary care data, we have previously found that people with IPF had an increased risk of acute coronary syndrome, angina and prescription of cardiovascular drugs compared to the general population, even before the diagnosis of IPF was made.…”

Section: Discussionmentioning

confidence: 99%

“…5 People with IPF who have severe coronary artery disease also appear to have worse outcomes. 5 Using UK primary care data, we have previously found that people with IPF had an increased risk of acute coronary syndrome, angina and prescription of cardiovascular drugs compared to the general population, even before the diagnosis of IPF was made. 3 We also found that the risk of acute coronary syndrome increased to three-fold in people with IPF compared to the general population after the diagnosis of IPF was established (RR 3.14, 95%CI: 2.02-4.87).…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] In a cohort of people referred for lung transplantation, Nathan and colleagues found significant coronary artery disease to be increased in people with IPF compared with people with chronic obstructive pulmonary disease (COPD), with worse outcomes for those with both IPF and coronary artery disease. 5 Using United Kingdom (UK) longitudinal electronic health records, we have previously demonstrated that people with IPF have an increased risk of cardiovascular disease even before the IPF diagnosis is made. 3 The reason behind this increase in cardiovascular disease seen in IPF is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Cardiovascular Disease in People With Idiopathic Pulmonary Fibrosis

Dalleywater

Powell

Hubbard

et al. 2015

Chest

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Rationale & ObjectivePeople with idiopathic pulmonary fibrosis (IPF) have been shown to be at an increased risk of cardiovascular disease but reasons for this are unknown. The aim of this study was to compare the prevalence of common cardiovascular risk factors in people with IPF and the general population and establish the incidence of ischaemic heart disease (IHD) and stroke after the diagnosis of IPF, controlling for these risk factors. MethodsWe used data from a large United Kingdom primary care database to identify incident cases of IPF and matched general population controls. We compared the prevalence of risk factors for cardiovascular disease and prescription of cardiovascular medications in people with IPF (before diagnosis) with general population controls, and assessed the incidence of IHD and stroke in people with IPF (after diagnosis) compared to controls. ResultsWe identified 3,211 cases of IPF and 12,307 controls. Cases with IPF were more likely to have a record of hypertension (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.19 -1.44), and diabetes (OR 1.20, 95% CI 1.07 -1.34) compared with controls; they were also more likely to have been prescribed several cardiovascular drugs. The rate of first time IHD events was more than twice as high in cases compared to controls (rate ratio [RR] 2.32, 95% CI 1.85-2.93; p<0.001) but the incidence of stroke was only marginally higher (p=0.09). Rate ratios for IHD and stroke were not altered substantially after adjusting for cardiovascular risk factors. 2 ConclusionSeveral cardiovascular risk factors were more prevalent in people with IPF; however this did not account for the increased rate of IHD in this group of patients. Abstract word count 257

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Cardiovascular Disease in People With Idiopathic Pulmonary Fibrosis

Dalleywater

Powell

Hubbard

et al. 2015

Chest

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“…During the follow up period, again there was an increased risk of acute coronary syndrome (RR, 3.14; 95% CI, 2.02 to 4.87) with the mean follow up of 2.7 years from the date of diagnosis of IPF. In a comparative study between transplant candidates for COPD and IPF, Nathan et al showed that the prevalence of CAD was found to be 65.8% in the IPF group compared to 46.1% in patients with COPD (p < 0.028) (26).…”

Section: Cardiac Arrhythmias and Ipfmentioning

confidence: 99%

“…Age, sex, ethnicity, smoking are the common predictors of mortality in IPF. Although, the most common cause of death in IPF patients is respiratory failure from progression of the disease, death due to cardiac disease have been reported in the patients (26). It has a significant impact on the mortality and hospitalizations related to IPF ( Table 1).…”

Section: Impact Of Cardiac Manifestations Of Ipfmentioning

confidence: 99%

Cardiac manifestations of idiopathic pulmonary fibrosis

Agrawal

Verma

Shah

et al. 2016

IRDR

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Prevalence of obstructive coronary artery disease in patients undergoing lung transplantation: Case series and review of the literature

Jones

Enfield

Mehrad

et al. 2013

Cathet Cardio Intervent

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Background Coronary angiography is commonly performed prior to lung transplantation, but its utility is unproven. Methods We conducted a single-center retrospective analysis of consecutive patients referred for coronary angiography as part of a pre-operative evaluation for lung transplantation and reviewed the literature for prior series. Results A total of 89 patients, 48 men and 41 women were included. Obstructive (≥ 70% stenosis) CAD was present in 9 (10%), non-obstructive (< 70% stenosis) CAD in 24 (27%), and no angiographic evidence of CAD in 56 (63%) patients. We found 13 previously published series in the literature, in which a total of 1998 patients underwent coronary angiography pre-lung transplant. Together with our 89 patients, obstructive CAD was found in 11%. Conclusions In conclusion, given the low prevalence of obstructive CAD in patients referred for lung transplantation, the inherent risk of angiography and unproven benefit of detection of obstructive CAD, the utility of routine coronary angiography in this population requires validation in prospective studies.

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Prevalence and impact of coronary artery disease in idiopathic pulmonary fibrosis

Abstract: 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.

Cited by 163 publications

References 21 publications

Risk Factors for Cardiovascular Disease in People With Idiopathic Pulmonary Fibrosis

Risk Factors for Cardiovascular Disease in People With Idiopathic Pulmonary Fibrosis

Cardiac manifestations of idiopathic pulmonary fibrosis

Prevalence of obstructive coronary artery disease in patients undergoing lung transplantation: Case series and review of the literature

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