with idiopathic pulmonary fibrosis (IPF) are three times as likely to experience
severe coronary events—including
heart attacks—than people
without the disease, according to a recent study that analyzed the risk of
cardiovascular disease in nearly 1,000 patients with IPF and more than 3,500
“If you look
at them over time, people with IPF have roughly a three-fold increased risk of
acute coronary syndrome, which is a greater increase than you get from smoking,”
said Richard B. Hubbard, M.D., British Lung Foundation professor of epidemiology
at the University
of Nottingham and lead
author of the study.
was published in the second issue for December of the American Thoracic
Society’s American Journal of Respiratory and Critical Care
and colleagues analyzed data from the computerized records of the
UK’s Health Improvement Network for
920 patients with idiopathic pulmonary fibrosis and 3,593 control subjects
without IPF for diagnoses of coronary events and disease incidence.
to having a markedly increased risk of heart problems, patients with IPF were 23
percent more likely to have angina, had a 60 percent higher risk of stroke, and
a three-fold increased risk of deep vein thrombosis, according to Dr. Hubbard.
those with IPF were more than twice as likely as control subjects to have been
prescribed amiodarone, a medication used for irregular heartbeats that has also
been implicated as a cause of fibrotic lung disease.
research could have serious implications for the 60,000
people with IPF who currently live in the United States
and the 21,000 people who receive this diagnosis for the first time each year.
the time of diagnosis is about
three years, and there are currently
treatments that have been shown to increase survival.
medical knowledge about IPF is limited. “We know that genetic factors play some
role in IPF because it clusters in families in about 10 percent of cases— and in
a similar number of people there is evidence that environmental factors, such as
exposure to metal dust at work and cigarette smoking may have a role,” said Dr.
Hubbard. “[But] studies from the U.S.A. and the U.K. suggest
that IPF is becoming more common, and the reasons for this are
investigations are required to better understand the relationship between IPF
and systemic vascular disease as well as the mechanisms shared by the two
syndromes,” wrote David Zisman, M.D., and Steven Kawut, M.D., in an editorial in
the same issue of the journal.
“[I]f a causal association were confirmed… the presence of IPF itself could
constitute a sufficiently potent risk factor for coronary artery disease such
that more aggressive goals in risk factor modification would be
mysterious disease as IPF raises a host of questions, but the most pressing ones
are about how to improve and extend the lives of its
IPF have got a very bad outlook, and we may need to focus on other aspects of
their health. The current guidelines are focused on palliative care so that
people get oxygen and their symptoms treated, but maybe patients should go on
heart prevention treatments right away,” Dr. Hubbard said. “Future strategies
could include a trial of anti-coagulant therapy in IPF patients,” he
Heffner, M.D., past president of the ATS, commented that this study introduces a
change in our thinking of IPF. “As with other chronic, progressive respiratory
disorders, the lungs in IPF may be the bellwether of other more systemic
pathogenic events. What is first expressed in the lung becomes manifest later in
other organ systems. This perspective will both realign research efforts and
also direct more comprehensive healthcare to patients diagnosed with early IPF.”
For full Article, view: http://www.thoracic.org/sections/publications/press-releases/resources/hubbard-ipf.pdf
Source : News release from American Thoracic Society on December 5, 2008.