title: Ischemic heart disease among subjects with and without chronic obstructive pulmonary disease--ECG-findings in a population-based cohort study.
abstract: BACKGROUND
  Cardiovascular comorbidity in COPD is common and contributes to increased mortality. A few population-based studies indicate that ischemic electrocardiogram (ECG)-changes are more prevalent in COPD, while others do not. The aim of the present study was to estimate the presence of ischemic heart disease (IHD) in a population-based COPD-cohort in comparison with subjects without COPD.
  
  
  METHODS
  All subjects with obstructive lung function (COPD, n = 993) were identified together with age- and sex-matched controls (non-COPD, n = 993) from population-based cohorts examined in 2002-04. In 2005, data from structured interview, spirometry and ECG were collected from 1625 subjects. COPD was classified into GOLD 1-4 after post-bronchodilator spirometry. Ischemic ECG-changes, based on Minnesota-coding, were classified according to the Whitehall criteria into probable and possible IHD.
  
  
  RESULTS
  Self-reported IHD was equally common in COPD and non-COPD, and so were probable and possible ischemic ECG-changes according to Whitehall. After excluding subjects with restrictive spirometric pattern from the non-COPD-group, similar comparison with regard to presence of IHD performed between those with COPD and those with normal lung-function did neither show any differences. There was a significant association between self-reported IHD (p = 0.007) as well as probable ischemic ECG-changes (p = 0.042), and increasing GOLD stage. In COPD there was a significant association between level of FEV1 percent of predicted and self-reported as well as probable ischemic ECG-changes, and this association persisted for self-reported IHD also after adjustment for sex and age.
  
  
  CONCLUSIONS
  In this population-based study, self-reported IHD and probable ischemic ECG-changes were associated with COPD disease severity assessed by spirometry.
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden. ulf.nilsson@umu.se.|Department of Public Health and Clinical Medicine, Division of Medicine, University Hospital of Northern Sweden, Umeå, 90185, Sweden. ulf.nilsson@umu.se.
authors.forename: Ulf
authors.initials: U
authors.lastname: Nilsson
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden. bengt.johansson@umu.se.
authors.forename: Bengt
authors.initials: B
authors.lastname: Johansson
authors.affiliation: Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. berne.eriksson@regionhalland.se.
authors.forename: Berne
authors.initials: B
authors.lastname: Eriksson
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden. anders.blomberg@umu.se.
authors.forename: Anders
authors.initials: A
authors.lastname: Blomberg
authors.affiliation: Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. bo.lundback@gu.se.
authors.forename: Bo
authors.initials: B
authors.lastname: Lundbäck
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden. anne.lindberg@umu.se.
authors.forename: Anne
authors.initials: A
authors.lastname: Lindberg
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D012907:Smoking / Q000453:epidemiology*; D013147:Spirometry; D013548:Sweden / Q000453:epidemiology; D013851:Thinness / Q000453:epidemiology; D014463:Ultrasonography