Association between pulmonary fibrosis and coronary artery disease.
BACKGROUND
Pulmonary fibrosis and atherosclerosis have many similarities at the histopathologic level. Moreover, fibrotic lung diseases exhibit systemic effects and have the potential to affect the vasculature beyond the lung. The existence of a relationship between the two, however, has not been studied.


METHODS
To investigate whether fibrotic lung disorders may predispose to atherosclerosis, we conducted a cross-sectional study of 630 patients referred for lung transplantation evaluation at a university hospital. We compared the prevalence of angiographic coronary artery disease (CAD) in patients with fibrotic vs nonfibrotic lung diseases.


RESULTS
Fibrotic lung diseases were associated with an increased prevalence of CAD compared with nonfibrotic diseases after adjustment for traditional risk factors (odds ratio, 2.18; 95% confidence interval, 1.17-4.06). The magnitude and significance of this association were maintained when only nongranulomatous fibrotic disease or its subset, idiopathic pulmonary fibrosis, was examined. The strength of the relationship between fibrotic disorders and CAD increased when multivessel disease was analyzed (odds ratio, 4.16; 95% confidence interval, 1.46-11.9). No significant association was detected for granulomatous fibrotic disorders (odds ratio, 1.56; 95% confidence interval, 0.47-5.16; P =.47), although this subgroup had fewer cases of CAD for analysis.


CONCLUSIONS
These findings support an association between fibrotic lung disorders and CAD. Further research is necessary to confirm this relationship and to explore the pathologic processes underlying, and potentially linking, these 2 conditions.
Division of Cardiology, Department of Medicine, Weill Medical College of Cornell University, New York, NY, USA.
Jorge R
JR
Kizer
David A
DA
Zisman
Nancy P
NP
Blumenthal
Robert M
RM
Kotloff
Stephen E
SE
Kimmel
Robert M
RM
Strieter
Selim M
SM
Arcasoy
Victor A
VA
Ferrari
John
J
Hansen-Flaschen
D000328:Adult; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D011658:Pulmonary Fibrosis / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology