Is chronic obstructive pulmonary disease under-diagnosed in patients with coronary artery disease? A tertiary care centre experience from central India

Abstract

Context: Although worldwide studies are available regarding the prevalence of COPD in CAD patients, data from India are sparse. Aims: The purpose of this study was to determine the prevalence of undiagnosed and therefore, untreated COPD in patients suffering from CAD. It would also attempt to establish the need for screening of patients diagnosed with CAD for COPD. Settings and Design: A cross-sectional, observational study carried out at the respiratory out patients department (OPD) of a tertiary care centre of armed forces over a period of one year. Methods and Material: 79 patients with angiographically proven CAD underwent spirometry to assess the prevalence of COPD. Statistical Analysis Used: Data analysis was done using SPSS (Statistical Package for Social Sciences) version 21.0. Results: The mean age of the patients was 62.49 years (±8.77). Mean smoking index was 235.88. Nine patients (11.39 %) were diagnosed to have COPD. All the patients diagnosed as COPD were male, >60 years old and had normal BMI. 88.9 % patients with COPD were smokers. On comparing the patients with and without COPD, a significant co-relation was found with LVEF (%) (P = 0.044). 44.4% patients had never been diagnosed with COPD. Conclusions: The prevalence of missed diagnosis of COPD is significant in our study. We recommend that at the time of diagnosis of CAD, the initial evaluation should include a detailed history, clinical examination and evaluation of lung function by spirometry.