title: Reliability of symptoms suggestive of angina in patients with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Due to overlapping symptoms and inadequate exercise capacity, noninvasive diagnosis of coronary artery disease (CAD) may be under- or overestimated in patients with chronic obstructive pulmonary disease (COPD).
  
  
  OBJECTIVE
  To assess outcomes of coronary angiography in COPD patients depending on baseline clinical characteristics.
  
  
  METHODS
  Medical records of 157 patients with COPD and 157 patients without COPD matched for baseline clinical characteristics who had undergone diagnostic coronary angiography for the first time were reviewed retrospectively.
  
  
  RESULTS
  The frequency of significant CAD was significantly lower in COPD patients than in the control group (52.8% vs. 80.2%, p<0.001). Frequencies of CAD risk factors (older age, hypertension, diabetes, smoking history) were significantly more frequent among COPD patients having significant CAD. Among patients reporting stable angina pectoris, significant CAD was detected in 32.7% of COPD patients and 71.0% of non-COPD patients (p<0.001). However, among the patients with a diagnosis of unstable angina pectoris, significant CAD was detected in 87.5% of COPD patients and 90.2% of non-COPD patients (p=0.755).
  
  
  CONCLUSIONS
  Diagnosis of CAD in COPD patients by symptomatology may be difficult. However, clinical diagnosis of CAD in the setting of unstable angina is accurate in most of the COPD patients. Therefore, further noninvasive diagnostic methods or careful follow up may be more appropriate for COPD patients reporting stable angina pectoris.
authors.affiliation: Yuzuncu Yil University, Faculty of Medicine, Cardiology Department, Van, Turkey. yilmazleman@yahoo.com
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Gunes
authors.forename: Mustafa
authors.initials: M
authors.lastname: Tuncer
authors.forename: Unal
authors.initials: U
authors.lastname: Guntekin
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Gumrukcuoglu
authors.forename: Serkan
authors.initials: S
authors.lastname: Akdag
authors.forename: Bulent
authors.initials: B
authors.lastname: Ozbay
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Sertogullarindan
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging*; D000789:Angina, Unstable / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging*; D014421:Turkey / Q000453:epidemiology