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Coronary artery disease and heart failure in patients with idiopathic pulmonary fibrosis

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Abstract

The aim of this study was to investigate the prevalence and prognostic value of coronary artery disease (CAD) and heart failure (HF) in patients with idiopathic pulmonary fibrosis (IPF). Thirteen hundred and fifty-eight patients with interstitial lung disease [851 (62%) males, mean age: 68 ± 10 years] were retrospectively analyzed. CAD was defined as (1) the presence of a clinical diagnosis of angina pectoris, (2) clinical diagnosis of a myocardial infarction, and (3) coronary angiography showing ≥ 1 vessel with a stenosis of > 75%. The definition of HF was made according to the modified Framingham criteria. Compared to the non-IPF group (n = 790), the IPF group (n = 568) had a significantly higher prevalence of CAD (9.3% vs. 4.4%, p < 0.001) and HF (8.2% vs. 3.7%, p < 0.001). During a median follow-up of 1.6 years, 152 deaths were identified. The patients with HF had a significantly worse prognosis than those without HF both in the non-IPF group and IPF group (both p < 0.05). However, the prognosis did not significantly differ between the patients with CAD and those without CAD both in the non-IPF group and IPF group. The presence of HF was an independent predictor of death in the IPF [hazard ratio (HR) 3.67, 95% confidence interval (CI) 1.57–8.56, p = 0.0025] and non-IPF (HR 5.07, 95% CI 1.44–17.86, p = 0.011) patients. The prevalence of CAD and HF was significantly higher in IPF than non-IPF patients. In addition, the presence of HF was a significant prognostic factor for both IPF and non-IPF patients. These results indicated that the importance of HF as a comorbidity for patients with ILD.

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Abbreviations

CAD:

Coronary artery disease

CI:

Confidence interval

COPD:

Chronic obstructive pulmonary disease

HF:

Heart failure

HR:

Hazard ratio

IPF:

Idiopathic pulmonary fibrosis

ILD:

Interstitial lung disease

OR:

Odds ratio

References

  1. Agrawal A, Verma I, Shah V, Agarwal A, Sikachi RR (2016) Cardiac manifestations of idiopathic pulmonary fibrosis. Intractable Rare Dis Res 5(2):70–75

    Article  Google Scholar 

  2. Ponnuswamy A, Manikandan R, Sabetpour A, Keeping IM, Finnerty JP (2009) Association between ischaemic heart disease and interstitial lung disease: a case-control study. Respir Med 103(4):503–507

    Article  CAS  Google Scholar 

  3. Kizer JR, Zisman DA, Blumenthal NP, Kotloff RM, Kimmel SE, Strieter RM, Arcasoy SM, Ferrari VA, Hansen-Flaschen J (2004) Association between pulmonary fibrosis and coronary artery disease. Arch Intern Med 164(5):551–556

    Article  Google Scholar 

  4. Nathan SD, Basavaraj A, Reichner C, Shlobin OA, Ahmad S, Kiernan J, Burton N, Barnett SD (2010) Prevalence and impact of coronary artery disease in idiopathic pulmonary fibrosis. Respir Med 104(7):1035–1041

    Article  Google Scholar 

  5. Hubbard RB, Smith C, Le Jeune I, Gribbin J, Fogarty AW (2008) The association between idiopathic pulmonary fibrosis and vascular disease: a population-based study. Am J Respir Crit Care Med 178(12):1257–1261

    Article  Google Scholar 

  6. Carter P, Lagan J, Fortune C, Bhatt DL, Vestbo J, Niven R, Chaudhuri N, Schelbert EB, Potluri R, Miller CA (2019) Association of cardiovascular disease with respiratory disease. J Am Coll Cardiol 73(17):2166–2177

    Article  Google Scholar 

  7. Panos RJ, Mortenson RL, Niccoli SA, King TE Jr (1990) Clinical deterioration in patients with idiopathic pulmonary fibrosis: causes and assessment. Am J Med 88(4):396–404

    Article  CAS  Google Scholar 

  8. Araki T, Katsura H, Sawabe M, Kida K (2003) A clinical study of idiopathic pulmonary fibrosis based on autopsy studies in elderly patients. Intern Med 42(6):483–489

    Article  Google Scholar 

  9. Daniels CE, Yi ES, Ryu JH (2008) Autopsy findings in 42 consecutive patients with idiopathic pulmonary fibrosis. Eur Respir J 32(1):170–174

    Article  CAS  Google Scholar 

  10. Rudd RM, Prescott RJ, Chalmers JC, Johnston ID, Fibrosing Alveolitis Subcommittee of the Research Committee of the British Thoracic S (2007) British Thoracic Society Study on cryptogenic fibrosing alveolitis: response to treatment and survival. Thorax 62(1):62–66

    Article  Google Scholar 

  11. Senni M, Tribouilloy CM, Rodeheffer RJ, Jacobsen SJ, Evans JM, Bailey KR, Redfield MM (1998) Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991. Circulation 98(21):2282–2289

    Article  CAS  Google Scholar 

  12. Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jimenez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O’Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P (2018) Heart disease and stroke statistics-2018 update: a report from the American Heart Association. Circulation 137(12):e67–e492

    Article  Google Scholar 

  13. Bild DE, Detrano R, Peterson D, Guerci A, Liu K, Shahar E, Ouyang P, Jackson S, Saad MF (2005) Ethnic differences in coronary calcification: the multi-ethnic study of atherosclerosis (MESA). Circulation 111(10):1313–1320

    Article  Google Scholar 

  14. Nasir K, Shaw LJ, Liu ST, Weinstein SR, Mosler TR, Flores PR, Flores FR, Raggi P, Berman DS, Blumenthal RS, Budoff MJ (2007) Ethnic differences in the prognostic value of coronary artery calcification for all-cause mortality. J Am Coll Cardiol 50(10):953–960

    Article  Google Scholar 

  15. Manolio TA, Arnold AM, Post W, Bertoni AG, Schreiner PJ, Sacco RL, Saad MF, Detrano RL, Szklo M (2008) Ethnic differences in the relationship of carotid atherosclerosis to coronary calcification: the multi-ethnic study of atherosclerosis. Atherosclerosis 197(1):132–138

    Article  CAS  Google Scholar 

  16. Raymakers AJN, Sadatsafavi M, Sin DD, De Vera MA, Lynd LD (2017) The impact of statin drug use on all-cause mortality in patients with COPD: a population-based cohort study. Chest 152(3):486–493

    Article  Google Scholar 

  17. Sin DD, Man SF (2007) Systemic inflammation and mortality in chronic obstructive pulmonary disease. Can J Physiol Pharmacol 85(1):141–147

    Article  CAS  Google Scholar 

  18. Antonopoulos AS, Margaritis M, Lee R, Channon K, Antoniades C (2012) Statins as anti-inflammatory agents in atherogenesis: molecular mechanisms and lessons from the recent clinical trials. Curr Pharm Des 18(11):1519–1530

    Article  CAS  Google Scholar 

  19. Murtha LA, Schuliga MJ, Mabotuwana NS, Hardy SA, Waters DW, Burgess JK, Knight DA, Boyle AJ (2017) The processes and mechanisms of cardiac and pulmonary fibrosis. Front Physiol 8:777

    Article  Google Scholar 

  20. McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, Mathier MA, McGoon MD, Park MH, Rosenson RS, Rubin LJ, Tapson VF, Varga J, Harrington RA, Anderson JL, Bates ER, Bridges CR, Eisenberg MJ, Ferrari VA, Grines CL, Hlatky MA, Jacobs AK, Kaul S, Lichtenberg RC, Moliterno DJ, Mukherjee D, Pohost GM, Schofield RS, Shubrooks SJ, Stein JH, Tracy CM, Weitz HH, Wesley DJ (2009) ACCF/AHA 2009 expert consensus document on pulmonary hypertension: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association: developed in collaboration with the American College of Chest Physicians, American Thoracic Society Inc, and the Pulmonary Hypertension Association. Circulation 119(16):2250–2294

    Article  Google Scholar 

  21. Patel NM, Lederer DJ, Borczuk AC, Kawut SM (2007) Pulmonary hypertension in idiopathic pulmonary fibrosis. Chest 132(3):998–1006

    Article  Google Scholar 

  22. Lettieri CJ, Nathan SD, Barnett SD, Ahmad S, Shorr AF (2006) Prevalence and outcomes of pulmonary arterial hypertension in advanced idiopathic pulmonary fibrosis. Chest 129(3):746–752

    Article  Google Scholar 

  23. Papadopoulos CE, Pitsiou G, Karamitsos TD, Karvounis HI, Kontakiotis T, Giannakoulas G, Efthimiadis GK, Argyropoulou P, Parharidis GE, Bouros D (2008) Left ventricular diastolic dysfunction in idiopathic pulmonary fibrosis: a tissue Doppler echocardiographic [corrected] study. Eur Respir J 31(4):701–706

    Article  CAS  Google Scholar 

  24. Rivera-Lebron BN, Forfia PR, Kreider M, Lee JC, Holmes JH, Kawut SM (2013) Echocardiographic and hemodynamic predictors of mortality in idiopathic pulmonary fibrosis. Chest 144(2):564–570

    Article  Google Scholar 

  25. Kato S, Sekine A, Kusakawa Y, Ogura T, Futaki M, Iwasawa T, Kirigaya H, Gyotoku D, Iinuma N, Iguchi K, Nakachi T, Fukui K, Kimura K, Umemura S (2015) Prognostic value of cardiovascular magnetic resonance derived right ventricular function in patients with interstitial lung disease. J Cardiovasc Magn Reson 17:10

    Article  Google Scholar 

Download references

Acknowledgments

We are grateful to John Martin for his English proofreading.

Funding

Research Grant, MSD Life Science Foundation, Public Interest Incorporated Foundation. Research Grant, Japan Society for the Promotion of Science: Grant-in-Aid for Early-Career Scientists.

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Authors and Affiliations

  1. Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan

    Shingo Kato, Keigo Hayakawa & Kazuki Fukui

  2. Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan

    Hideya Kitamura, Erina Tabata, Ryota Otoshi & Takashi Ogura

  3. Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan

    Tae Iwasawa

  4. Department of Radiology, Yokohama City University, Yokohama, Kanagawa, Japan

    Daisuke Utsunomiya

  5. Department of Cardiology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan

    Kazuo Kimura

  6. Department of Medical Science and Cardiorenal Medicine, Yokohama City University, Yokohama, Kanagawa, Japan

    Kouichi Tamura

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  1. Shingo Kato
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  2. Hideya Kitamura
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  3. Keigo Hayakawa
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  11. Takashi Ogura
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Correspondence to Shingo Kato.

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Kato, S., Kitamura, H., Hayakawa, K. et al. Coronary artery disease and heart failure in patients with idiopathic pulmonary fibrosis. Heart Vessels 36, 1151–1158 (2021). https://doi.org/10.1007/s00380-021-01787-1

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  • DOI: https://doi.org/10.1007/s00380-021-01787-1

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