Ischemic heart disease makes COPD symptoms worse both at rest and during exacerbations, without increasing the frequency of COPD exacerbations, according to an epidemiologic study by Patel et al.

They prospectively observed 386 Londoners with COPD for one year, 64 of whom had ischemic heart disease (with or without history of myocardial infarction, defined by chart review). Compared to those with COPD without coronary artery disease, those with CAD had:

• More breathlessness at baseline -- 51% had an MRC score > 4, compared to 35% of those without ischemic heart disease.

• They walked 225 meters in 6 minutes, compared to 317 in the CAD-free COPD group.

• They did not have more COPD exacerbations (1.95 vs. 1.86 per year), but they had a median of 5 more days with symptoms.

Authors report their findings held up after multivariate analysis for age, gender, and FEV1.

Patel ARC et al. The Impact of Ischemic Heart Disease on Symptoms, Health Status and Exacerbations in COPD. CHEST 2011; ePub September 22, 2011.