Assessment of the impact of concomitant chronic obstructive pulmonary disease on the outcomes of acute coronary syndrome


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Background. In patients with chronic obstructive pulmonary disease (COPD), the most common comorbid disease is coronary artery heart disease (CAD), including acute coronary syndrome (ACS). Assessment of the severity of the clinical course of COPD and the ventilation function of the lungs plays an important role in the choice of drug therapy and in predicting the outcome of ACS. Objective. Assessment of the severity of the clinical course of COPD and impaired ventilation function depending on the outcomes of ACS, as well as to determination of their correlation with the blood troponin T(TNT) level. Methods. The study included 54 patients (29 men and 25 women) aged 49 to 72 years (65.2±7.3 years) hospitalized with a diagnosis of ACS and concomitant COPD. Taking into account the outcomes of ACS, patients were divided into two groups: group 1 - 30 patients with acute myocardial infarction (MI); group 2 - 24 patients with progressive unstable angina. All underwent spirometry and CAT-test (the chronic obstructive pulmonary disease assessment test), and also determination of the blood TNT level. Results. Compared to group 2, exacerbation of COPD during hospitalization was more frequent in group 1: 80.0% versus 41.7% (p=0.009). Also, in group 1, the TNT level in patients with exacerbation of COPD was higher than in patients without exacerbation: 0.927±0.289 and 0.592±0.149 ng/ml, respectively (p=0.005). The values of the forced expiratory volume in 1 second (FEV1) and the Tiffeneau index in the presence of exacerbation of COPD in the group 1were lower than in the group 2: on average by 17.7 (p=0.028) and 12.6% (p=0.01), respectively. The TNT level correlated inversely with FEV1 (p=0.014) and directly with the CAT-test score (p=0.003). Conclusion. It was revealed that severe clinical symptoms and severe airflow restriction during exacerbations of COPD in hospitalized patients with ACS are often associated with the development of acute MI and elevated blood troponin T levels.

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B. Iskenderov

Penza Institute for Advanced Medical Education - Branch of the Russian Medical Academy of Continuous Professional Education

Email: iskenderovbg@mail.m
Dr. Sci. (Med.), Professor, Department of the Internal Medicine, Cardiology, Functional Diagnostics and Rheumatology 8A, Stasova str., Penza 440060, Russian Federation

N. Berenshtein

Penza Institute for Advanced Medical Education - Branch of the Russian Medical Academy of Continuous Professional Education

Department of Therapy, Cardiology, Functional Diagnostics and Rheumatology, Department of Radiology Penza, Russia

T. Lokhina

Penza Institute for Advanced Medical Education - Branch of the Russian Medical Academy of Continuous Professional Education

Department of Therapy, Cardiology, Functional Diagnostics and Rheumatology, Department of Radiology Penza, Russia

I. Mozhzhukhina

Penza Institute for Advanced Medical Education - Branch of the Russian Medical Academy of Continuous Professional Education

Department of Therapy, Cardiology, Functional Diagnostics and Rheumatology, Department of Radiology Penza, Russia

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