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Acute coronary syndrome in patients with chronic obstructive pulmonary disease—epidemiology, pathophysiology, and treatment

Simona Nikolaeva

Abstract

Cardiovascular diseases and especially ischemic heart disease are the most common comorbidities in patients with chronic obstructive pulmonary disease. The overlap of important risk factors, such as smoking and advanced age, determines the frequent combination of both diseases. There is evidence that, in addition to common risk factors, they are interrelated by common pathogenetic mechanisms. Chronic inflammation leads to the circulation of cytokines and mediators that can accelerate the development of atherosclerosis. Acute pulmonary inflammation predisposes to the development of acute cardiac events through similar mechanisms, including autonomic dysregulation leading to arrhythmia, increased coagulation, and acute coronary syndrome. The prevalence of chronic obstructive pulmonary disease among persons with acute coronary syndrome is estimated to be 5 to 18%, and this comorbidity further worsens the prognosis. The overlapping pathophysiological mechanisms in these two diseases also suggests a complex approach to treatment.


Keywords

chronic obstructive disease, ischemic heart disease, pathophysiological mechanisms, beta blockers

Full Text


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DOI: http://dx.doi.org/10.14748/hl.v27i1.9320

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