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Airway obstruction and the risk of myocardial infarction and death from coronary heart disease: a national health examination survey with a 33-year follow-up period

  • RESPIRATORY EPIDEMIOLOGY
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Abstract

Chronic obstructive pulmonary disease (COPD) has been associated with coronary mortality. Yet, data about the association between COPD and acute myocardial infarction (MI) remain scarce. We aimed to study airway obstruction as a predictor of MI and coronary mortality among 5576 Finnish adults who participated in a national health examination survey between 1978 and 1980. Subjects underwent spirometry, had all necessary data, showed no indications of cardiovascular disease at baseline, and were followed up through record linkage with national registers through 2011. The primary outcome consisted of a major coronary event—that is, hospitalization for MI or coronary death, whichever occurred first. We specified obstruction using the lower limit of normal categorization. Through multivariate analysis adjusted for potential confounding factors for coronary heart disease, hazard ratios (HRs) (with the 95% confidence intervals in parentheses) of a major coronary event, MI, and coronary death reached 1.06 (0.79–1.42), 0.84 (0.54–1.31), and 1.40 (1.04–1.88), respectively, in those with obstruction compared to others. However, in women aged 30–49 obstruction appeared to predict a major coronary event, where the adjusted HR reached 4.21 (1.73–10.28). In conclusion, obstruction appears to predict a major coronary event in younger women only, whereas obstruction closely associates with the risk of coronary death independent of sex and age.

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Acknowledgements

A Doctoral Candidate Position at the University of Helsinki/Hospital District of Helsinki and Uusimaa (from June 2016) awarded to the first author allowed for the write-up of our analysis. We wish to thank Vanessa Fuller for English-language revisions to this manuscript.

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Authors and Affiliations

  1. Heart and Lung Center, Helsinki University Hospital, Meilahti Triangle Hospital, HUS, 6th Floor, PO Box 372, 00029, Helsinki, Finland

    Tiina Mattila

  2. Doctoral Program in Clinical Research, University of Helsinki, Helsinki, Finland

    Tiina Mattila

  3. National Institute for Health and Welfare, PO Box 30, 00271, Helsinki, Finland

    Tiina Mattila, Harri Rissanen, Paul Knekt, Pauli Puukka & Markku Heliövaara

  4. Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, PO Box 52, Hämeentie 11, 20521, Turku, Finland

    Tuula Vasankari

  5. Finnish Lung Health Association (FILHA), Filha ry, Sibeliuksenkatu 11 A 1, 00250, Helsinki, Finland

    Tuula Vasankari

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  1. Tiina Mattila
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Correspondence to Tiina Mattila.

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Conflict of interest

The corresponding author Tiina Mattila completed this study through financial support from the Hospital District of Helsinki and Uusimaa (a Doctoral Candidate Position in the Doctoral Programme of Clinical Research at the University of Helsinki/Hospital District of Helsinki and Uusimaa from June 2016). Statistical analyses in this study were completed by the corresponding author and the National Institute for Health and Welfare in Helsinki, Finland as a function of that agency’s work. All other co-authors completed the work related to this study as a function of their regular duties. The corresponding author and none of the other authors have any relevant conflicts of interest.

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Mattila, T., Vasankari, T., Rissanen, H. et al. Airway obstruction and the risk of myocardial infarction and death from coronary heart disease: a national health examination survey with a 33-year follow-up period. Eur J Epidemiol 33, 89–98 (2018). https://doi.org/10.1007/s10654-017-0278-3

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