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Multicenter Study
. 2025 May 8;15(5):e097851.
doi: 10.1136/bmjopen-2024-097851.

Prevalence of microspirometry-detected chronic obstructive pulmonary disease in two European cohorts of patients hospitalised for acute myocardial infarction: a cross-sectional study

William A E Parker #  1   2 , Josefin Sundh #  3 , Jonas Oldgren  4   5 , Pontus Andell  6   7 , Christian Reitan  8 , Tomas Jernberg  8 , Robin Hofmann  9 , Moman A Mohammad  10 , David Erlinge  10 , Axel Akerblom  4   5 , Sofia Sederstam Lawesson  11 , Kyriakos V Konstantinidis  12 , Johan Lindbäck  5 , Christer Janson  4 , Anna Björkenheim  13   14 , Nadir Elamin  15 , Hannah McMellon  15 , Bethany Moyle  15 , Mehul Patel  16 , Jad El-Khoury  17 , Raulin Surujbally  18 , Robert F Storey #  19   2 , Stefan K James #  4   5
Affiliations
Multicenter Study

Prevalence of microspirometry-detected chronic obstructive pulmonary disease in two European cohorts of patients hospitalised for acute myocardial infarction: a cross-sectional study

William A E Parker et al. BMJ Open. .

Abstract

Objectives: To establish the prevalence of clinically significant chronic obstructive pulmonary disease (COPD) and relevant characteristics in individuals with a significant smoking history who are hospitalised for acute myocardial infarction (MI).

Design: Cross-sectional study.

Setting: Hospital inpatients at 8 European centres (7 in Sweden, 1 in the UK).

Participants: 518 men or women (302 in Sweden, 216 in the UK) hospitalised for acute MI, aged 40 years or older, with a smoking history of at least 10 pack-years.

Primary and secondary outcome measures: The primary outcome was prevalence of detected significant COPD (Global Initiative for Chronic Obstructive Lung Disease stages 2-4), defined as a ratio of forced expiratory volume in 1 and 6 s (FEV1/FEV6) <0.7 and FEV1 <80% of the predicted value, measured using microspirometry. Secondary outcome measures were prior diagnosis of COPD, prescription of inhaled corticosteroids (ICS), symptom burden (COPD Assessment Test (CAT)) and blood eosinophil count.

Results: The prevalence of significant COPD was 91/518 (18% (95% CI 14 to 21)) with no difference between the countries. Of those with detected significant COPD, 69 (76%) had no previous COPD diagnosis. A CAT score >10 was found in 65%, and a blood eosinophil count of ≥100/mm3 and ≥300/mm3 was found in 76% and 20%, respectively. Inhaled corticosteroids were used by 15% of the patients.

Conclusions: In a cohort of patients hospitalised for acute MI in Sweden and the UK, one in five patients with a history of smoking was found to have significant COPD based on microspirometry. Symptom burden was high and treatment rates with ICS low. Among those diagnosed with COPD, three out of four had not been previously diagnosed with COPD.

Keywords: Epidemiology; Myocardial infarction; Pulmonary Disease, Chronic Obstructive; Respiratory Function Test.

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Conflict of interest statement

Competing interests: WAEP discloses research support and personal fees from AstraZeneca. JS reports personal fees for educational activities and lectures from AstraZeneca, Boehringer Ingelheim, Chiesi and Novartis. JO reports institutional research grants/support from Amgen, AstraZeneca, Bayer, Novartis, and Roche Diagnostics. CR reports research support from MSD. RH reports lecture fees to institution from AstraZeneca and Pfizer. AÅ is an employee of Boehringer Ingelheim. KVK, MP, JE-K and RS are employees of AstraZeneca and hold stock and/or stock options in the company. CJ has received honoraria for educational activities and lectures from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Orion, and TEVA, and has served on advisory boards arranged by AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Orion. and TEVA. RFS reports institutional research grants/support from AstraZeneca and Cytosorbents; and personal fees from Alfasigma, AstraZeneca, Boehringer Ingelheim/Lilly, Chiesi, Cytosorbents, Daiichi Sankyo, Idorsia, Novartis, Novo Nordisk, Pfizer, PhaseBio and Tabuk. SKJ reports institutional research grants/support from Amgen, AstraZeneca, Novartis, Jansen. The other authors have no disclosures.

Figures

Figure 1
Figure 1. Proportion of participants in each enrolled cohort with Global Initiative on Chronic Obstructive Lung Disease (GOLD) stage 2–4 chronic obstructive pulmonary disease (COPD). Dots and whiskers indicate proportion with a 95% CI.
Figure 2
Figure 2. Presence of (A) prior diagnosis of chronic obstructive pulmonary disease (COPD); (B) receiving inhaled corticosteroid (ICS); and (C) high symptom burden defined as COPD Assessment Test (CAT) score of 10 or greater, in the subgroup of participants with detected significant COPD. Dots and whiskers indicate proportion ±95% CI.
Figure 3
Figure 3. Peripheral blood eosinophil counts in study participants with detected significant chronic obstructive pulmonary disease. Bars indicate proportion +95% CI.
See this image and copyright information in PMC

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