• Raza ullah hayat abad medical complex peshawar
  • Shahid Salam TMO at pulmonolgy ward KTH peshawar
  • Tahir Ghaffar FCPS medicine, fellow endocrinology at endocrinology ward HMC peshawar
  • Rahim Muhammad pulmonology TMO at pulmonology ward KTH peshawar
  • Imran Khan


Background: Chronic obstructive airway disease (COPD) is considered as risk factor for coronary artery disease (CAD) along with other risk factors. This study was conducted to determine the frequency of undiagnosed chronic obstructive pulmonary disease in patients with coronary artery disease. Methods: This cross-sectional study was conducted in the Pulmonology and Cardiology wards/OPD’s of Khyber Teaching Hospital Peshawar. Patients more than 35 years of age, diagnosed with CAD of either gender were included. Patients already diagnosed with COPD, recent myocardial infarction (within 7 days), left ventricular impairment, pneumothorax, bronchiectasis, comatose patient, asthmatic and those with chest trauma were excluded. All the patients underwent spirometry examination before and after administration of salbutamol (5 mg for 5 minutes) via nebulizer. FEV1/FVC less than 70% confirmed the presence of COPD. Results: Out of 151 patients, 57 (37.7%) were found to have COPD. Among them, 39 (68.42%) were male and 18 (31.57%) were female. Among male patients with COPD, 82.05% (n=32) were smokers and 17.94% (n=7) were nonsmokers while in females with COPD no one was smoker. Conclusion: COPD is an under-diagnosed progressive disease in patients with high risk patients with coronary artery disease.Keywords: Chronic Obstructive Airway Disease; Coronary Artery Disease

Author Biography

Raza ullah, hayat abad medical complex peshawar

junior registrar endocrinology ward HMC peshawar


Lazovic B, Svenda MZ, Mazic S, Stajic Z, Delic M. Analysis of electrocardiogram in chronic obstructive pulmonary disease patients. Med Pregl 2013;66(3-4):126–9.

Murarescu ED, Mitrofan EC, Mihailovici MS. Chronic obstructive pulmonary disease in a new concept. Rom J Morphol Embryol 2007;48(3):207–14.

Abbas S, Kitchlew AR, Abbas S. Disease burden of ischemic heart disease in Pakistan and its risk factors. Ann Pak Inst Med Sci 2009;5(3):145–50.

Cazzola M, Proietto A, Matera MG. Indacaterol for chronic obstructive pulmonary disease (COPD). Drugs Today (Barc) 2010;46(3):139–50.

Yusuf MO. Systems for the management of respiratory disease in primary care – an international series: Pakistan. Prim Care Respir J 2009;18(1):3–9.

Hilbert RJ, Isonaka S, George D, Iqbal A. Interpreting COPD prevalence estimates: what is the true burden of disease? Chest 2003;123(5):1684–92.

Leberl M, Kratzer A, Taraseviciene-Stewart L. Tobacco smoke induced COPD/emphysema in the animal model-are we all on the same page? Front Physiol 2013;4:91.

Chiba H, Abe S. The environmental risk factors for COPD--tobacco smoke, air pollution, chemicals. Nihon Rinsho 2003;61(12):2101–6.

Sin DD, Man SF. Why are patients with chronic obstructive pulmonary disease at increased risk of cardiovascular diseases? The potential role of systemic inflammation in chronic obstructive pulmonary disease. Circulation 2003;107(11):1514–19.

Soriano JB, Rigo F, Guerrero D, Yanez A, Forteza JF, Frontera G, et al. High prevalence of undiagnosed airflow limitation in patients with cardiovascular disease. Chest 2010;137(2):333–40.

Roversi S, Roversi P, Spadafora G, Rossi R, Fabbri LM. Coronary artery disease concomitant with chronic obstructive pulmonary disease. Eur J Clin Invest 2014;44(1):93–102.

Doll R, Peto R, Wheatley K, Gray R, Sutherland I. Mortality in relation to smoking: 40 years’ observations on male British doctors. BMJ 1994;309(6959):901–11.

Higgins MW, Enright PL, Kronmal RA, Schenker MB, Anton-Culver H, Lyles M. Smoking and lung function in elderly men and women. The Cardiovascular Health Study. JAMA 1993;269(21):2741–8.

Sidney S, Sorel M, Quesenberry CP Jr, DeLuise C, Lanes S, Eisner MD. COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente Medical Care Program. Chest 2005;128(4):2068–75.

Anthonisen NR, Connett JE, Kiley JP, Altose MD, Bailey WC, Buist AS, et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1. The Lung Health Study. JAMA 1994;272(19):1497–505.

Sin DD, Man SF. Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality. Proc Am Thorac Soc 2005;2(1):8–11.

Fabbri LM, Rabe KF. From COPD to chronic systemic inflammatory syndrome? Lancet 2007;370(9589):797–9.

Bodi V, Sanchis J, Nunez J, Mainar L, Minana G, Benet I, et al. Uncontrolled immune response in acute myocardial infarction: unraveling the thread. Am Heart J 2008;156(6):1065–73.

Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD. COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J 2009;34(2):380–6.

Brekke PH, Omland T, Smith P, Soyseth V. Underdiagnosis of myocardial infarction in COPD - Cardiac Infarction Injury Score (CIIS) in patients hospitalised for COPD exacerbation. Respir Med 2008;102(9):1243–7.

WRI. United Nations Environment Program, United Nations Development Programet al 1998–99 World resources: a guide to the global environment. Oxford University Press; 1999.

Albalak R, Frisancho AR, Keeler GJ. Domestic biomass fuel combustion and chronic bronchitis in two rural Bolivian villages. Thorax 1999;54(11):1004–8.

Trupin L, Earnest G, San Pedro M, Balmes JR, Eisner MD, Yelin E, et al. The occupational burden of chronic obstructive pulmonary disease. Eur Respir J 2003;22(3):462–9.

Chiba H, Abe S. The environmental risk factors for COPD-tobacco smoke, air pollution, chemicals. Nihon Rinsho 2003;61(12):2101–6.

Castaldi PJ, Cho MH, Cohn M, Langerman F, Moran S, Tarragona N, et al. The COPD genetic association compendium: a comprehensive online database of COPD genetic associations. Hum Mol Genet 2010;19(3):526

Leberl M, Kratzer A, Taraseviciene-Stewart L. Tobacco smoke induced COPD/emphysema in the animal model—are we all on the same page? Front Physiol 2013;4:91.

Celli BR, MacNee W, ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23(6):932–46.

Siafakas NM, Vermeire P, Pride NB, Paoletti P, Gibson J, Howard P, et al. Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European respiratory society task force. Eur Respir J 1995;8(8):1398–420.

Abbasi IN, Ahsan A, Nafees AA. Correlation of respiratory symptoms and spirometric lung patterns in a rural community setting, Sindh, Pakistan: a cross sectional survey. BMC Pulm Med 2012;12:81.



Most read articles by the same author(s)