Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmada
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFS |
Texto Completo: | http://ri.ufs.br/jspui/handle/riufs/7641 |
Resumo: | BACKGROUND: Systemic inflammation is the pathophysiological link between coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD). However, the influence of underdiagnosed COPD on patients with suspected or diagnosed CAD is unknown. Therefore, the objective was to evaluate the degree of coronary involvement in COPD patients with suspected or confirmed CAD. Methods: For this cross-sectional study which we carried out March 2015 and June 2017, 210 outpatients with suspected or confirmed CAD were concomitantly underwent spirometry and coronary angiography or multidetector computed tomography. Two groups were defined: with and without COPD. Size, site, extent, and calcification of the coronary lesions, and the severity of COPD were analyzed. Results: COPD patients (n=101) presented: higher frequency of obstructive coronary lesions ≥ 50% 72 (71.3%), multi-vessels 29 (28.7%), of the left main 18 (17.8%), atherosclerotic plaques more calcified and higher Agatston coronary calcium score than the patients without COPD (p < 0.0001). The greater COPD in the GOLD stages, the more severe the CAD and the more calcified the coronary plaques (p < 0.0001). However, there was no difference between the two groups with respect to the main risk factors for CAD. In the univariate analysis, the COPD and the male gender have been risk predictors for CAD. In the multivariate analysis adjusted to COPD was independent predictor of obstructive CAD (odds ratio 4.78; CI 95% 2.21-10.34; p < 0.001). Conclusion: In patients with suspected or diagnosed CAD, the COPD was associated with a higher severity and extent of coronary lesions, calcific plaques, and elevated calcium score independently of the established risk factors for CAD. In addition, the more severe the COPD, the greater the severity of coronary lesions and calcification. |
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Mota, Igor LarchertOliveira, Joselina Luzia MenezesAlmeida, Maria Luiza Doria2018-04-02T18:50:36Z2018-04-02T18:50:36Z2018-02-16MOTA, Igor Larchert. Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD i a iii) e doença arterial coronária suspeita ou confirmada. 2018. 65 f. Tese (Doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2018.http://ri.ufs.br/jspui/handle/riufs/7641BACKGROUND: Systemic inflammation is the pathophysiological link between coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD). However, the influence of underdiagnosed COPD on patients with suspected or diagnosed CAD is unknown. Therefore, the objective was to evaluate the degree of coronary involvement in COPD patients with suspected or confirmed CAD. Methods: For this cross-sectional study which we carried out March 2015 and June 2017, 210 outpatients with suspected or confirmed CAD were concomitantly underwent spirometry and coronary angiography or multidetector computed tomography. Two groups were defined: with and without COPD. Size, site, extent, and calcification of the coronary lesions, and the severity of COPD were analyzed. Results: COPD patients (n=101) presented: higher frequency of obstructive coronary lesions ≥ 50% 72 (71.3%), multi-vessels 29 (28.7%), of the left main 18 (17.8%), atherosclerotic plaques more calcified and higher Agatston coronary calcium score than the patients without COPD (p < 0.0001). The greater COPD in the GOLD stages, the more severe the CAD and the more calcified the coronary plaques (p < 0.0001). However, there was no difference between the two groups with respect to the main risk factors for CAD. In the univariate analysis, the COPD and the male gender have been risk predictors for CAD. In the multivariate analysis adjusted to COPD was independent predictor of obstructive CAD (odds ratio 4.78; CI 95% 2.21-10.34; p < 0.001). Conclusion: In patients with suspected or diagnosed CAD, the COPD was associated with a higher severity and extent of coronary lesions, calcific plaques, and elevated calcium score independently of the established risk factors for CAD. In addition, the more severe the COPD, the greater the severity of coronary lesions and calcification.INTRODUÇÃO: A inflamação sistêmica constitui o elo fisiopatológico entre a doença arterial coronariana (DAC) e a doença pulmonar obstrutiva crônica (DPOC). Todavia a influência da DPOC não diagnosticada em pacientes com DAC suspeita ou diagnosticada é desconhecida. Portanto, objetivou-se avaliar o grau de acometimento coronariano em portadores de DPOC com DAC suspeita ou confirmada. MÉTODOS: Estudo transversal realizado entre março de 2015 a junho de 2017 com 210 pacientes ambulatoriais, com DAC suspeita ou confirmada, submetidos, ao concomitantemente, à espirometria e à cineangiocoronariografia ou à angiotomografia computadorizada das coronárias. A partir dos resultados definiram-se os grupos: com e sem DPOC. Foram analisadas tamanho, local, extensão e calcificação da lesão coronária, e gravidade da DPOC. RESULTADOS: O grupo com DPOC, com 101 (48%) voluntários, apresentou, comparativamente ao sem DPOC: maior frequência de DAC (88,1% vs 45%); de lesões obstrutivas ≥ 50% (71,3% vs 21,1%); de lesões multiarteriais (28,7% vs 8,3%); maior percentual de lesões de tronco da coronária esquerda (17,8% vs 3,7%); mais lesões graves (61,4% vs 10,1%); placas ateroscleróticas mais calcificadas e escore de cálcio mais elevado (p<0,0001). Quanto mais grave o estágio da DPOC (GOLD), mais grave a DAC e mais calcificadas as placas coronárias (p<0,0001). Entretanto, não houve diferenças entre os grupos quanto aos principais fatores de risco para DAC. Na análise univariada, a DPOC e o gênero masculino foram preditores de risco para DAC. Na análise multivariada ajustada apenas a DPOC foi preditora de DAC obstrutiva (odds ratio 4,78; IC95% 2,21-10,34; p<0,001). CONCLUSÃO: Em pacientes com DAC suspeita ou confirmada, a DPOC foi associada a maior gravidade e extensão das lesões coronárias, placas calcificadas e escore de cálcio elevados, independente, dos fatores de risco para DAC já estabelecidos. Além disso, quanto mais grave a DPOC maior a gravidade das lesões e calcificação coronárias.Fundação de Apoio a Pesquisa e à Inovação Tecnológica do Estado de Sergipe - FAPITEC/SEAracajuporCiências da saúdeDoença pulmonar obstrutiva crônica (DPOC)Doença da artéria coronarianaEspirometriaTomografia computadorizada multidetectoresAngiografia coronáriaChronic obstructive pulmonary disease (COPD)Coronary artery diseaseSpirometryCoronary angiographyMultidetector computed tomographyCIENCIAS DA SAUDELesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmadaCoronary lesions in patients with copd (GOLD STAGE I to III) and suspected or confirmed coronary arterial diseaseinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisPós-Graduação em Ciências da SaúdeUniversidade Federal de Sergipereponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/7641/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALIGOR_LARCHERT_MOTA.pdfIGOR_LARCHERT_MOTA.pdfapplication/pdf743644https://ri.ufs.br/jspui/bitstream/riufs/7641/2/IGOR_LARCHERT_MOTA.pdf55159d05d1d3c4bef0b86c5d43d88dbcMD52TEXTIGOR_LARCHERT_MOTA.pdf.txtIGOR_LARCHERT_MOTA.pdf.txtExtracted texttext/plain134524https://ri.ufs.br/jspui/bitstream/riufs/7641/3/IGOR_LARCHERT_MOTA.pdf.txt38ade6a76772f06a41f8b22bc95c7e1bMD53THUMBNAILIGOR_LARCHERT_MOTA.pdf.jpgIGOR_LARCHERT_MOTA.pdf.jpgGenerated Thumbnailimage/jpeg1275https://ri.ufs.br/jspui/bitstream/riufs/7641/4/IGOR_LARCHERT_MOTA.pdf.jpg28d94c68add87c98812819f13b6a3460MD54riufs/76412018-04-02 15:50:36.274oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2018-04-02T18:50:36Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.pt_BR.fl_str_mv |
Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmada |
dc.title.alternative.eng.fl_str_mv |
Coronary lesions in patients with copd (GOLD STAGE I to III) and suspected or confirmed coronary arterial disease |
title |
Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmada |
spellingShingle |
Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmada Mota, Igor Larchert Ciências da saúde Doença pulmonar obstrutiva crônica (DPOC) Doença da artéria coronariana Espirometria Tomografia computadorizada multidetectores Angiografia coronária Chronic obstructive pulmonary disease (COPD) Coronary artery disease Spirometry Coronary angiography Multidetector computed tomography CIENCIAS DA SAUDE |
title_short |
Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmada |
title_full |
Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmada |
title_fullStr |
Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmada |
title_full_unstemmed |
Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmada |
title_sort |
Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD I a III) e doença arterial coronária suspeita ou confirmada |
author |
Mota, Igor Larchert |
author_facet |
Mota, Igor Larchert |
author_role |
author |
dc.contributor.author.fl_str_mv |
Mota, Igor Larchert |
dc.contributor.advisor1.fl_str_mv |
Oliveira, Joselina Luzia Menezes |
dc.contributor.advisor-co1.fl_str_mv |
Almeida, Maria Luiza Doria |
contributor_str_mv |
Oliveira, Joselina Luzia Menezes Almeida, Maria Luiza Doria |
dc.subject.por.fl_str_mv |
Ciências da saúde Doença pulmonar obstrutiva crônica (DPOC) Doença da artéria coronariana Espirometria Tomografia computadorizada multidetectores Angiografia coronária |
topic |
Ciências da saúde Doença pulmonar obstrutiva crônica (DPOC) Doença da artéria coronariana Espirometria Tomografia computadorizada multidetectores Angiografia coronária Chronic obstructive pulmonary disease (COPD) Coronary artery disease Spirometry Coronary angiography Multidetector computed tomography CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Chronic obstructive pulmonary disease (COPD) Coronary artery disease Spirometry Coronary angiography Multidetector computed tomography |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
BACKGROUND: Systemic inflammation is the pathophysiological link between coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD). However, the influence of underdiagnosed COPD on patients with suspected or diagnosed CAD is unknown. Therefore, the objective was to evaluate the degree of coronary involvement in COPD patients with suspected or confirmed CAD. Methods: For this cross-sectional study which we carried out March 2015 and June 2017, 210 outpatients with suspected or confirmed CAD were concomitantly underwent spirometry and coronary angiography or multidetector computed tomography. Two groups were defined: with and without COPD. Size, site, extent, and calcification of the coronary lesions, and the severity of COPD were analyzed. Results: COPD patients (n=101) presented: higher frequency of obstructive coronary lesions ≥ 50% 72 (71.3%), multi-vessels 29 (28.7%), of the left main 18 (17.8%), atherosclerotic plaques more calcified and higher Agatston coronary calcium score than the patients without COPD (p < 0.0001). The greater COPD in the GOLD stages, the more severe the CAD and the more calcified the coronary plaques (p < 0.0001). However, there was no difference between the two groups with respect to the main risk factors for CAD. In the univariate analysis, the COPD and the male gender have been risk predictors for CAD. In the multivariate analysis adjusted to COPD was independent predictor of obstructive CAD (odds ratio 4.78; CI 95% 2.21-10.34; p < 0.001). Conclusion: In patients with suspected or diagnosed CAD, the COPD was associated with a higher severity and extent of coronary lesions, calcific plaques, and elevated calcium score independently of the established risk factors for CAD. In addition, the more severe the COPD, the greater the severity of coronary lesions and calcification. |
publishDate |
2018 |
dc.date.accessioned.fl_str_mv |
2018-04-02T18:50:36Z |
dc.date.available.fl_str_mv |
2018-04-02T18:50:36Z |
dc.date.issued.fl_str_mv |
2018-02-16 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
MOTA, Igor Larchert. Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD i a iii) e doença arterial coronária suspeita ou confirmada. 2018. 65 f. Tese (Doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2018. |
dc.identifier.uri.fl_str_mv |
http://ri.ufs.br/jspui/handle/riufs/7641 |
identifier_str_mv |
MOTA, Igor Larchert. Lesões coronárias em pacientes com doença pulmonar obstrutiva crônica (GOLD i a iii) e doença arterial coronária suspeita ou confirmada. 2018. 65 f. Tese (Doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2018. |
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http://ri.ufs.br/jspui/handle/riufs/7641 |
dc.language.iso.fl_str_mv |
por |
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por |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Pós-Graduação em Ciências da Saúde |
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Universidade Federal de Sergipe |
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