Systematic review and meta-analysis of prevalence of undiagnosed major cardiac comorbidities in COPD
Background It is often stated that heart disease is underdiagnosed in COPD. Evidence for this statement comes from primary studies, but these have not been synthesised to provide a robust estimate of the burden of undiagnosed heart disease. Methods A systematic review of studies using active diagnos...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2023-11-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/9/6/00548-2023.full |
| _version_ | 1797362078895308800 |
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| author | Joseph Kibbler Clare Wade Grace Mussell David P. Ripley Stephen C. Bourke John Steer |
| author_facet | Joseph Kibbler Clare Wade Grace Mussell David P. Ripley Stephen C. Bourke John Steer |
| author_sort | Joseph Kibbler |
| collection | DOAJ |
| description | Background
It is often stated that heart disease is underdiagnosed in COPD. Evidence for this statement comes from primary studies, but these have not been synthesised to provide a robust estimate of the burden of undiagnosed heart disease.
Methods
A systematic review of studies using active diagnostic techniques to establish the prevalence of undiagnosed major cardiac comorbidities in patients with COPD was carried out. MEDLINE, Embase, Scopus and Web of Science were searched for terms relating to heart failure (specifically, left ventricular systolic dysfunction (LVSD), coronary artery disease (CAD) and atrial fibrillation), relevant diagnostic techniques and COPD. Studies published since 1980, reporting diagnosis rates using recognised diagnostic criteria in representative COPD populations not known to have heart disease were included. Studies were classified by condition diagnosed, diagnostic threshold used and whether participants had stable or exacerbated COPD. Random-effects meta-analysis of prevalence was conducted where appropriate.
Results
In general, prevalence estimates for undiagnosed cardiac comorbidities in COPD had broad confidence intervals, with significant study heterogeneity. Most notably, a prevalence of undiagnosed LVSD of 15.8% (11.1–21.1%) was obtained when defined as left ventricular ejection fraction <50%. Undiagnosed CAD was found in 2.3–18.0% of COPD patients and atrial fibrillation in 1.4% (0.3–3.5%).
Conclusion
Further studies using recent diagnostic advances, and investigating therapeutic interventions for patients with COPD and heart disease are needed. |
| first_indexed | 2024-03-08T16:02:24Z |
| format | Article |
| id | doaj.art-47e5f8085f564419a76847c63edd50b3 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-08T16:02:24Z |
| publishDate | 2023-11-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-47e5f8085f564419a76847c63edd50b32024-01-08T09:57:43ZengEuropean Respiratory SocietyERJ Open Research2312-05412023-11-019610.1183/23120541.00548-202300548-2023Systematic review and meta-analysis of prevalence of undiagnosed major cardiac comorbidities in COPDJoseph Kibbler0Clare Wade1Grace Mussell2David P. Ripley3Stephen C. Bourke4John Steer5 Northumbria Healthcare NHS Foundation Trust, Respiratory Medicine, North Shields, UK Northumbria University, Sport, Exercise and Rehabilitation, Newcastle upon Tyne, UK Northumbria Healthcare NHS Foundation Trust, Respiratory Medicine, North Shields, UK Northumbria Healthcare NHS Foundation Trust, Respiratory Medicine, North Shields, UK Northumbria Healthcare NHS Foundation Trust, Respiratory Medicine, North Shields, UK Northumbria Healthcare NHS Foundation Trust, Respiratory Medicine, North Shields, UK Background It is often stated that heart disease is underdiagnosed in COPD. Evidence for this statement comes from primary studies, but these have not been synthesised to provide a robust estimate of the burden of undiagnosed heart disease. Methods A systematic review of studies using active diagnostic techniques to establish the prevalence of undiagnosed major cardiac comorbidities in patients with COPD was carried out. MEDLINE, Embase, Scopus and Web of Science were searched for terms relating to heart failure (specifically, left ventricular systolic dysfunction (LVSD), coronary artery disease (CAD) and atrial fibrillation), relevant diagnostic techniques and COPD. Studies published since 1980, reporting diagnosis rates using recognised diagnostic criteria in representative COPD populations not known to have heart disease were included. Studies were classified by condition diagnosed, diagnostic threshold used and whether participants had stable or exacerbated COPD. Random-effects meta-analysis of prevalence was conducted where appropriate. Results In general, prevalence estimates for undiagnosed cardiac comorbidities in COPD had broad confidence intervals, with significant study heterogeneity. Most notably, a prevalence of undiagnosed LVSD of 15.8% (11.1–21.1%) was obtained when defined as left ventricular ejection fraction <50%. Undiagnosed CAD was found in 2.3–18.0% of COPD patients and atrial fibrillation in 1.4% (0.3–3.5%). Conclusion Further studies using recent diagnostic advances, and investigating therapeutic interventions for patients with COPD and heart disease are needed.http://openres.ersjournals.com/content/9/6/00548-2023.full |
| spellingShingle | Joseph Kibbler Clare Wade Grace Mussell David P. Ripley Stephen C. Bourke John Steer Systematic review and meta-analysis of prevalence of undiagnosed major cardiac comorbidities in COPD ERJ Open Research |
| title | Systematic review and meta-analysis of prevalence of undiagnosed major cardiac comorbidities in COPD |
| title_full | Systematic review and meta-analysis of prevalence of undiagnosed major cardiac comorbidities in COPD |
| title_fullStr | Systematic review and meta-analysis of prevalence of undiagnosed major cardiac comorbidities in COPD |
| title_full_unstemmed | Systematic review and meta-analysis of prevalence of undiagnosed major cardiac comorbidities in COPD |
| title_short | Systematic review and meta-analysis of prevalence of undiagnosed major cardiac comorbidities in COPD |
| title_sort | systematic review and meta analysis of prevalence of undiagnosed major cardiac comorbidities in copd |
| url | http://openres.ersjournals.com/content/9/6/00548-2023.full |
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