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Prevalence of Myocardial Infarction With Obstructive and Non-Obstructive Coronary Arteries in a Middle-Aged Population With Chronic Airflow Limitation : A Cross-Sectional Study

Sundh, Josefin ; Ekström, Magnus LU orcid ; Blomberg, Anders ; Lindberg, Eva ; Malinovschi, Andrei ; Olin, Anna Carin ; Sköld, C. Magnus ; Torén, Kjell ; Wollmer, Per LU and Östgren, Carl Johan LU , et al. (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.

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organization
publishing date
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
2025-08-15 14:50:56
@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 (&gt;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}},
}