Prevalence of Myocardial Infarction With Obstructive and Non-Obstructive Coronary Arteries in a Middle-Aged Population With Chronic Airflow Limitation : A Cross-Sectional Study
(2025) In International Journal of COPD 20. p.303-312- Abstract
Purpose: Myocardial infarctions (MIs) can occur in underlying obstructive coronary artery disease (MI-CAD) or in non-obstructive coronary arteries (MINOCA). The primary objectives of the study were to investigate the prevalence of MI-CAD and MINOCA in people with CAL, and to explore if CAL is an independent risk factor for MI-CAD and MINOCA. Secondary objectives were to explore these research questions stratified by sex and by smoking history. Patients and Methods: Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) of people aged 50–64 years. CAL was defined as a post-bronchodilator ratio of forced expiratory volume in one second and forced vital capacity below 0.70. MI-CAD was defined as a... (More)
Purpose: Myocardial infarctions (MIs) can occur in underlying obstructive coronary artery disease (MI-CAD) or in non-obstructive coronary arteries (MINOCA). The primary objectives of the study were to investigate the prevalence of MI-CAD and MINOCA in people with CAL, and to explore if CAL is an independent risk factor for MI-CAD and MINOCA. Secondary objectives were to explore these research questions stratified by sex and by smoking history. Patients and Methods: Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) of people aged 50–64 years. CAL was defined as a post-bronchodilator ratio of forced expiratory volume in one second and forced vital capacity below 0.70. MI-CAD was defined as a self-reported MI with coronary computed tomography angiography findings of previous revascularization or at least one significant coronary stenosis (>50%), and MINOCA as self-reported MI with no previous revascularization and no significant coronary stenosis. Results: In total, 1735 (8.3%) of 20,882 included participants had CAL. MI-CAD was more common than MINOCA both in people with (2.8 vs 0.6%) and without CAL (1.2 vs 0.3%). Compared with those without CAL, people with CAL had an almost doubled independent risk of both MI-CAD ([adjusted OR] 1.72; [95% CI] 1.22–2.42) and MINOCA (1.99; 1.02–3.86). In men, CAL was associated with increased risk of MINOCA (2.63; 1.23–5.64), and in women with increased risk for MI-CAD (3.43; 1.68–1.26). Conclusion: Middle-aged people with CAL have an almost doubled risk of both MI-CAD and MINOCA, compared with people without CAL. In contrast to people without CAL, the risk of MINOCA is increased in men and the risk of MI-CAD is increased in women. In a clinical context, both MI types should be considered in CAL.
(Less)
- author
- organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- COPD, coronary atherosclerosis, sex, smoking
- in
- International Journal of COPD
- volume
- 20
- pages
- 10 pages
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- scopus:85218459781
- pmid:39963296
- ISSN
- 1176-9106
- DOI
- 10.2147/COPD.S477986
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2025 Sundh et al.
- id
- 5b63702e-aaf0-452c-aa07-1ecf16600d26
- date added to LUP
- 2025-07-04 11:00:40
- date last changed
- 2025-08-01 13:34:33
@article{5b63702e-aaf0-452c-aa07-1ecf16600d26, abstract = {{<p>Purpose: Myocardial infarctions (MIs) can occur in underlying obstructive coronary artery disease (MI-CAD) or in non-obstructive coronary arteries (MINOCA). The primary objectives of the study were to investigate the prevalence of MI-CAD and MINOCA in people with CAL, and to explore if CAL is an independent risk factor for MI-CAD and MINOCA. Secondary objectives were to explore these research questions stratified by sex and by smoking history. Patients and Methods: Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) of people aged 50–64 years. CAL was defined as a post-bronchodilator ratio of forced expiratory volume in one second and forced vital capacity below 0.70. MI-CAD was defined as a self-reported MI with coronary computed tomography angiography findings of previous revascularization or at least one significant coronary stenosis (>50%), and MINOCA as self-reported MI with no previous revascularization and no significant coronary stenosis. Results: In total, 1735 (8.3%) of 20,882 included participants had CAL. MI-CAD was more common than MINOCA both in people with (2.8 vs 0.6%) and without CAL (1.2 vs 0.3%). Compared with those without CAL, people with CAL had an almost doubled independent risk of both MI-CAD ([adjusted OR] 1.72; [95% CI] 1.22–2.42) and MINOCA (1.99; 1.02–3.86). In men, CAL was associated with increased risk of MINOCA (2.63; 1.23–5.64), and in women with increased risk for MI-CAD (3.43; 1.68–1.26). Conclusion: Middle-aged people with CAL have an almost doubled risk of both MI-CAD and MINOCA, compared with people without CAL. In contrast to people without CAL, the risk of MINOCA is increased in men and the risk of MI-CAD is increased in women. In a clinical context, both MI types should be considered in CAL.</p>}}, author = {{Sundh, Josefin and Ekström, Magnus and Blomberg, Anders and Lindberg, Eva and Malinovschi, Andrei and Olin, Anna Carin and Sköld, C. Magnus and Torén, Kjell and Wollmer, Per and Östgren, Carl Johan and Jernberg, Tomas}}, issn = {{1176-9106}}, keywords = {{COPD; coronary atherosclerosis; sex; smoking}}, language = {{eng}}, pages = {{303--312}}, publisher = {{Dove Medical Press Ltd.}}, series = {{International Journal of COPD}}, title = {{Prevalence of Myocardial Infarction With Obstructive and Non-Obstructive Coronary Arteries in a Middle-Aged Population With Chronic Airflow Limitation : A Cross-Sectional Study}}, url = {{http://dx.doi.org/10.2147/COPD.S477986}}, doi = {{10.2147/COPD.S477986}}, volume = {{20}}, year = {{2025}}, }