Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are common chronic diseases with shared risk factors. COPD continues to be largely under diagnosed and undertreated especially in patient with CAD. We aimed to describe the prevalence of COPD in Tunisian smokers with CAD.

In a cross-sectional study conducted in FSI hospital in Tunisia, smoking patients (≥10pack-year) with confirmed CAD were recruited. Pre and post-bronchodilator spirometry was undertaken for all participants. COPD was defined according to GOLD criteria, as post-bronchodilator forced expiratory volume in 1sec/forced vital capacity (FEV₁/FVC) of <70%.

Spirometry was undertaken for 122 men with mean age of 59.3±9.5 years and mean pack-year of 52.3±28.3. Mean CAD follow-up duration was 3.9±4.5 years. The prevalence of COPD was 19.7%. Of the 24patients with COPD, 17patients were newly diagnosed. Of these patients, six had mild COPD, 15had moderate COPD, two had severe COPD and one had very severe COPD. The average FEV1 in COPD patients was 68.7%. COPD-related symptoms were: chronic cough (56%), dyspnea (76%), and wheezes (28%). Pulmonary arterial hypertension was observed in 36% of COPD patients. The comparison of patients with COPD with those without COPD showed that respiratory symptoms, chest-X-ray abnormality and pulmonary arterial hypertension were significantly more frequent in COPD patients.

There was a high prevalence of COPD among patients with CAD and most were under diagnosed despite having respiratory symptoms. Smokers with CAD and respiratory symptoms should be evaluated for airflow limitation and the presence of COPD.