Chronic obstructive pulmonary disease and coronary disease: COPDCoRi, a simple and effective algorithm for predicting the risk of coronary artery disease in COPD patients

Mario Cazzolae， Luigino Calzetta， Maria Gabriella Matera， Saverio Muscoli， Paola Rogliani， Francesco Romeo

Background

Chronic obstructive pulmonary disease (COPD) is often associated with cardiovascular artery disease (CAD), representing a potential and independent risk factor for cardiovascular morbidity. Therefore, the aim of this study was to identify an algorithm for predicting the risk of CAD in COPD patients.

Methods

We analyzed data of patients afferent to the Cardiology ward and the Respiratory Diseases outpatient clinic of Tor Vergata University (2010–2012, 1596 records). The study population was clustered as training population (COPD patients undergoing coronary arteriography), control population (non-COPD patients undergoing coronary arteriography), test population (COPD patients whose records reported information on the coronary status). The predicting model was built via causal relationship between variables, stepwise binary logistic regression and Hosmer–Lemeshow analysis. The algorithm was validated via split-sample validation method and receiver operating characteristics (ROC) curve analysis. The diagnostic accuracy was assessed.

Results

In training population the variables gender (men/women OR: 1.7, 95%CI: 1.237–2.5, P < 0.05), dyslipidemia (OR: 1.8, 95%CI: 1.2–2.5, P < 0.01) and smoking habit (OR: 1.5, 95%CI: 1.2–1.9, P < 0.001) were significantly associated with CAD in COPD patients, whereas in control population also age and diabetes were correlated. The stepwise binary logistic regressions permitted to build a well fitting predictive model for training population but not for control population. The predictive algorithm shown a diagnostic accuracy of 81.5% (95%CI: 77.78–84.71) and an AUC of 0.81 (95%CI: 0.78–0.85) for the validation set.

Conclusions

The proposed algorithm is effective for predicting the risk of CAD in COPD patients via a rapid, inexpensive and non-invasive approach.

respiratory medicine

August 2015Volume 109, Issue 8, Pages 1019–1025

DOI: http://dx.doi.org/10.1016/j.rmed.2015.05.021 |