Acute Coronary Syndrome in Patients of Chronic Obstructive Pulmonary Disease and Its Relationship with Brachial Artery Flow Mediated Dilatation

Abstract

Background:Both Chronic obstructive pulmonary disease (COPD) and Coronary artery disease (CAD) are closely related etiologically as well as pathophysiologically. Prevalence of both the diseases is rising to a great extent and have become one of the major causes of mortality and morbidity worldwide. Objectives:Present study was carried out in order to study prevalence of CAD among patients of COPD and identify high risk patients via BAFMD (Brachial artery flow mediated dilatation).Materials and Methods:Present cross sectional study was conducted in Medicine Department of a tertiary care hospital over a duration of one year on randomly selected cases of COPD, using pre-designed validated questionnaire. All cases underwent spirometry; cardiac evaluation via electrocardiography and echocardiography; and BAFMD was studied via Doppler USG.Result:The prevalence of CAD in COPD patients was found to be 24%. The prevalence of CAD correlated well with the severity of COPD i.e. 25% in GOLD staging III/IV as compared to 2.5% in GOLD staging I/II. Also, BAFMD was severely impaired in patients who had evidence of CAD. Mean value of BAFMD was significantly low in patients who had CAD as compared to those without CAD (5.37± 2.36% vs 9.20± 2.50%). Conclusion:We recommend the screening of patients of COPD via BAFMD and Echocardiography, for identifying high risk patients and early detection of cardiac involvement giving time for proper preventive and treatment measures for better outcomes.