Understanding the Relation between COPD and Coronary Artery Disease

Coronary artery disease (CAD) is one of the leading causes of mortality in chronic obstructive pulmonary disease (COPD). Right ventricular hypertrophy and ischemia are known to occur in COPD due to secondary pulmonary hypertension, but there is a significant link between COPD & CAD, regarding etiology, pathophysiology and precipitating factors. There is a definite role of smoking, respiratory muscle strength and lung function (independent of the effect of smoking) and inflammatory markers, which predisposes the patient of COPD to CAD. Even precipitating factors for acute exacerbation of COPD like infections, hyperglycemia or enzyme matrix metalloproteinase (MMP) have a role to play in acute coronary syndrome. Steroids given for COPD in long term can contribute to CAD and statins have a beneficial role to play in COPD also. We should look for CAD in patients of COPD before severe left ventricular dysfunction sets in.