Clinical and Anamnestic Features of Patients with Ischemic Heart Disease and Chronic Obstructive Pulmonary Disease
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Stable ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) often coexist due to their high prevalence and common risk factors. The study aimed to assess the anamnestic features, risk factors, clinical course, and prognosis in patients with IHD-COPD comorbidity. Methods and Results: A total of 333 patients with IHD-COPD comorbidity (183 men and 150 women; mean age of 63.53±10.06 years) were included in this study. Stable IHD was verified in accordance with the 2014 ACC/AHA guideline. The diagnosis of COPD was established following GOLD report (2023). All patients were divided into four age groups: 18-44 years, 45-59 years, 60-74 years, and 75-90 years. The analysis showed that as age increased, the frequency of IHD-COPD comorbidity rose from 2.7% to 54.95%. The peak of the IHD-COPD comorbidity was most often observed at the age of 60-74. Among comorbid patients under 75 years of age, men were represented to a slightly greater extent than women, and vice versa at the age of ≥75 years. The proportion of smokers was 3.3 times higher in the age group of ≤44 years compared to the group of ≥75 years. With increasing age, the percentage of smokers among patients decreased (P<0.01). Regardless of age, most patients with IHD and COPD were overweight. An increase in the age of patients with IHD and COPD was accompanied by a progressive decrease in SpO2. So, in the age group of ≥75 years, SpO₂ was 89.9%, while for the age group of ≤44 years, it was 94% (P=0.0013). A significant increase in the level of CRP, a key factor in the destabilization of IHD and COPD, was also associated with an increase in the age of patients with IHD-COPD comorbidity (P=0.0000). Combinations of “chest pain + dyspnea + weakness + cough + sputum” and “chest pain + dyspnea + weakness + syncope + palpitations + leg edema + cough + sputum” were significantly more common than other symptom combinations in both men and women (27.3% and 21.8% in men and 26.6% and 21.3% in women, respectively) (P<0.0001). The Charlson comorbidity index (CCI) in patients with IHD-COPD comorbidity was 4.37±0.99 points. In the age group of ≤44 years, the mean CCI score was 2.88±0.60, corresponding to a survival rate of 77.2±3.6%. In the 45-59 age category, the CCI score was 3.42±0.49, with a survival rate of 67.1±1.2%. In the age group of 60-74 years, the CCI score was 4.65±0.64, corresponding to a survival rate of 33.4±1.4%. In the age group of ≥75 years, the CCI score was 5.70±0.66, corresponding to a survival rate of 9.27±1.5%. Differences between age groups were highly significant (P=0.000). Conclusion: COPD and IHD share common risk factors, pathophysiological processes, and clinical symptoms and act synergistically as negative prognostic factors. Understanding pathophysiological mechanisms and clinical aspects of the IHD-COPD comorbidity opens perspectives for rational management strategies.
Authors: Oybek Urinov, Khurshid G. Fozilov, Dilorom E. Abidova, Shahzoda A. Samidjanova
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4408194543