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Prevalence and under-diagnosis of airflow limitation and other lung function abnormalities in patients with ischaemic heart disease: an interim analysis of the ALICE study

Joan Soriano, Nicolas Roche, John Cockcroft, Klaus Rabe, Mark Kearney, Guy Brusselle, Frits Franssen, Francisco Garcia Rio, Bo Lundbäck, Helen Marsden, Hana Muellerova, Paul Bloomfield, Gilbert Nadeau, Mathieu Vasselle, Zoe Adams, Angus Henderson, Leo Fabbri
European Respiratory Journal 2012 40: P450; DOI:
Joan Soriano
1Fundación Caubet-CIMERA Illes Balears, CIMERA, Bunyola, Spain
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Nicolas Roche
3Respiratory and Intensive Care Medicine, Hôtel-Dieu Hospital, University Paris Descartes, Paris, France
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John Cockcroft
4Wales Heart Research Institute, Cardiff University School of Medicine, Cardiff, United Kingdom
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Klaus Rabe
9Department of Medicine, University Kiel, Germany
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Mark Kearney
7Multidisciplinary Cardiovascular Research Centre, University of Leeds Medical School, United Kingdom
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Guy Brusselle
5Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
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Frits Franssen
2Program Development Centre, CIRO, Horn, Netherlands
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Francisco Garcia Rio
11Hospital La Paz, IdiPAZ, Madrid, Spain
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Bo Lundbäck
8Dept of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
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Helen Marsden
10Respiratory Centre of Excellence, GlaxoSmithKline, Uxbridge, United Kingdom
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Hana Muellerova
10Respiratory Centre of Excellence, GlaxoSmithKline, Uxbridge, United Kingdom
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Paul Bloomfield
10Respiratory Centre of Excellence, GlaxoSmithKline, Uxbridge, United Kingdom
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Gilbert Nadeau
10Respiratory Centre of Excellence, GlaxoSmithKline, Uxbridge, United Kingdom
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Mathieu Vasselle
12Excellence Medicale, GSK France, Marly Le Roi, France
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Zoe Adams
10Respiratory Centre of Excellence, GlaxoSmithKline, Uxbridge, United Kingdom
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Angus Henderson
10Respiratory Centre of Excellence, GlaxoSmithKline, Uxbridge, United Kingdom
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Leo Fabbri
6Department of Oncology Haematology and Respiratory Diseases, Section of Respiratory Diseases, University of Modena & Reggio Emilia, Modena, Italy
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Abstract

Background: Although ischaemic heart disease (IHD) and chronic pulmonary diseases, eg COPD, share similar risk factors, the prevalence and rate of diagnosis of airflow limitation (AL) compatible with COPD, and other lung function abnormalities, in patients with IHD are largely unknown.

Methods: In a cross-sectional study conducted in 15 sites across nine European countries (Belgium, France, Germany, Greece, Ireland, Italy, the Netherlands, Spain, and Sweden), we investigated the prevalence of airflow limitation compatible with COPD (defined as post-bronchodilator (BD) FEV1/FVC <0.70) and other lung function abnormalities in outpatients with documented IHD who were ≥40 years, and current or former smokers. Each participant completed a core questionnaire and performed full pre- and post-BD spirometry. Quality control of spirometry readings was performed by a centralized system.

Results: Up to April 2012, we studied 1803 evaluable IHD patients, 86.0% male, mean±SD age of 65.0±9.8 years. The prevalence of AL was 30.6% (95% C.I. 28.5%-32.8%, n=552) and, from 547 with available data, only 29.4% (n=161) of these had a prior diagnosis of COPD. In addition, we found a restrictive lung disease prevalence of 11.0% (defined as pre BD FVC<80% predicted and post BD FEV1/FVC≥70% predicted) in a subset of 1685 patients with available data.

Conclusions: Airflow limitation, compatible with COPD, and spirometry results suggestive of restrictive lung disease are frequent in individuals with IHD and are largely under-diagnosed, which has implications for the treatment and prognosis of both respiratory and cardiovascular diseases.

  • COPD - diagnosis
  • Epidemiology
  • Comorbidities
  • © 2012 ERS
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Prevalence and under-diagnosis of airflow limitation and other lung function abnormalities in patients with ischaemic heart disease: an interim analysis of the ALICE study
Joan Soriano, Nicolas Roche, John Cockcroft, Klaus Rabe, Mark Kearney, Guy Brusselle, Frits Franssen, Francisco Garcia Rio, Bo Lundbäck, Helen Marsden, Hana Muellerova, Paul Bloomfield, Gilbert Nadeau, Mathieu Vasselle, Zoe Adams, Angus Henderson, Leo Fabbri
European Respiratory Journal Sep 2012, 40 (Suppl 56) P450;

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Prevalence and under-diagnosis of airflow limitation and other lung function abnormalities in patients with ischaemic heart disease: an interim analysis of the ALICE study
Joan Soriano, Nicolas Roche, John Cockcroft, Klaus Rabe, Mark Kearney, Guy Brusselle, Frits Franssen, Francisco Garcia Rio, Bo Lundbäck, Helen Marsden, Hana Muellerova, Paul Bloomfield, Gilbert Nadeau, Mathieu Vasselle, Zoe Adams, Angus Henderson, Leo Fabbri
European Respiratory Journal Sep 2012, 40 (Suppl 56) P450;
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