TY - JOUR T1 - Treatable Cardiac Disease in Hospitalised COPD Exacerbations JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00756-2020 SP - 00756-2020 AU - Paul Leong AU - Martin I MacDonald AU - Paul King AU - Christian R Osadnik AU - Brian S Ko AU - Shane A Landry AU - Kais Hamza AU - Ahilan Kugenasan AU - John M Troupis AU - Philip G Bardin Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2020/11/12/23120541.00756-2020.abstract N2 - Introduction Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) are accompanied by escalations in cardiac risk superimposed upon elevated baseline risk. Appropriate treatment for coronary artery disease (CAD) and heart failure with reduced ejection fraction (HFrEF) could improve outcomes. However, securing these diagnoses during AECOPD is difficult, so their true prevalence remains unknown, as does the magnitude of this treatment opportunity. We aimed to determine the prevalence of severe CAD and severe HFrEF during hospitalised AECOPD using dynamic computed tomography (CT).Methods Cross-sectional study of 148 patients with hospitalised AECOPD. Dynamic CT was used to identify severe CAD (Agatston score≥400) and HFrEF (left ventricular ejection fraction ≤40% and/or right ventricular ejection fraction ≤35%).V Severe CAD was detected in 51/148 patients (35%), left ventricular systolic dysfunction was identified in 12 cases (8%) and right ventricular systolic dysfunction was present in 18 (12%). Clinical history and examination did not identify severe CAD in approximately one-third of cases and missed HFrEF in two-thirds of cases. Elevated troponin and BNP did not differentiate subjects with severe CAD from non-severe CAD, nor distinguish HFrEF from normal ejection fraction. Under-treatment was common. Of those with severe CAD, only 39% were prescribed an antiplatelet agent, and 53% received a statin. Of individuals with HFrEF, 50% or less received angiotensin blockers, beta-blocker, or antimineralocorticoids.Conclusion Dynamic CT detects clinically covert CAD and HFrEF during AECOPD, identifying opportunities to improve outcomes via well-established cardiac treatments.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Leong has nothing to disclose.Conflict of interest: Dr. MacDonald has nothing to disclose.Conflict of interest: Dr. King has nothing to disclose.Conflict of interest: Dr. Osadnik has nothing to disclose.Conflict of interest: Dr. Ko reports personal fees from Canon Medical, during the conduct of the study;.Conflict of interest: Dr. Landry has nothing to disclose.Conflict of interest: Dr. Hamza has nothing to disclose.Conflict of interest: Dr. Kugenasan has nothing to disclose.Conflict of interest: Dr. Troupis has nothing to disclose.Conflict of interest: Dr. Bardin has nothing to disclose. ER -