title: Lung Function Abnormalities in Smokers with Ischemic Heart Disease.
abstract: The aim of the ALICE (Airflow Limitation in Cardiac Diseases in Europe) study was to investigate the prevalence of airflow limitation in patients with ischemic heart disease and the effects on quality of life, healthcare use, and future health risk.
  
  
  
  To examine prebronchodilator and post-bronchodilator spirometry in outpatients aged greater than or equal to 40 years with clinically documented ischemic heart disease who were current or former smokers.
  
  
  
  This multicenter, cross-sectional study was conducted in 15 cardiovascular outpatient clinics in nine European countries. Airflow limitation was defined as post-bronchodilator FEV1/FVC less than 0.70.
  
  
  
  Among the 3,103 patients with ischemic heart disease who were recruited, lung function was defined for 2,730 patients. Airflow limitation was observed in 30.5% of patients with ischemic heart disease: 11.3% had mild airflow limitation, 15.8% moderate airflow limitation, 3.3% severe airflow limitation, and 0.1% very severe airflow limitation. Most patients with airflow limitation (70.6%) had no previous spirometry testing or diagnosed pulmonary disease. Airflow limitation was associated with greater respiratory symptomatology, impaired health status, and more frequent emergency room visits (P < 0.05).
  
  
  
  Airflow limitation compatible with chronic obstructive pulmonary disease affects almost one-third of patients with ischemic heart disease. Although airflow limitation is associated with additional morbidity and societal burden, it is largely undiagnosed and untreated. Clinical trial registered with www.clinicaltrials.gov (NCT 01485159).
authors.affiliation: 1 Department of Research and Education, CIRO+, Horn, the Netherlands.
authors.forename: Frits M E
authors.initials: FM
authors.lastname: Franssen
authors.affiliation: 2 Instituto de Investigación Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Joan B
authors.initials: JB
authors.lastname: Soriano
authors.affiliation: 3 Service de Pneumologie, Hôpital Cochin, AP-HP and Université Paris Descartes (EA2511), Sorbonne Paris Cité, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Roche
authors.affiliation: 4 Respiratory Franchise Medical, GSK, Uxbridge, United Kingdom.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Bloomfield
authors.affiliation: 5 Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Brusselle
authors.affiliation: 6 Section of Metabolic Medicine, Department of Medicine, NOCSAE Hospital, AUSMO, Baggiovara, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Leonardo M
authors.initials: LM
authors.lastname: Fabbri
authors.affiliation: 7 Servicio de Neumología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, IdiPAZ, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: García-Rio
authors.affiliation: 8 Leeds Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, United Kingdom.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Kearney
authors.affiliation: 4 Respiratory Franchise Medical, GSK, Uxbridge, United Kingdom.
authors.forename: Namhee
authors.initials: N
authors.lastname: Kwon
authors.affiliation: 9 Institute of Medicine/Krefting Research Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Lundbäck
authors.affiliation: 10 LungenClinic Grosshansdorf, Airway Research Centre North, German Centre for Lung Research, Grosshansdorf and Christian-Albrechts University, Kiel, Germany.
authors.forename: Klaus F
authors.initials: KF
authors.lastname: Rabe
authors.affiliation: 11 Direction Médicale de l'Excellence Opérationnelle, GSK, Marly-Le-Roi, France; and.
authors.forename: Alice
authors.initials: A
authors.lastname: Raillard
authors.affiliation: 4 Respiratory Franchise Medical, GSK, Uxbridge, United Kingdom.
authors.forename: Hana
authors.initials: H
authors.lastname: Muellerova
authors.affiliation: 12 Wales Heart Research Institute, Cardiff University, Cardiff, United Kingdom.
authors.forename: John R
authors.initials: JR
authors.lastname: Cockcroft
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D011788:Quality of Life; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013147:Spirometry
chemical_list: D001993:Bronchodilator Agents
keywords: airflow limitation; chronic obstructive pulmonary disease; ischemic heart disease; prevalence; smoking