Top

BMC Cardiovascular Disorders

Published in:

Open Access 01-12-2023 | Spirometry | Research

The relationship between preserved ratio impaired spirometry and mortality in the myocardial infarction survivors: a population-based cohort study

Authors: Dan Li, Zhishen Ruan, Shen Xie, Shunchao Xuan, Hengyi Zhao, Bo Wu

Published in: BMC Cardiovascular Disorders | Issue 1/2023

Abstract

Introduction

Preserved ratio impaired spirometry (PRISm) is a subtype of pulmonary function abnormality which is characterized by a proportional reduction in non-obstructive expiratory lung volume. Currently, no studies have shown a relationship between PRISm and mortality in myocardial infarction (MI) survivors.

Methods

We used cohort data from U.S. adults who attended the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012. According to the ratio of forced expiratory volume in the first second (FEV₁) to forced vital capacity (FVC), we divided lung function into normal spirometry (FEV₁/ FVC) ≥ 70%, FEV₁ ≥ 80%), PRISm (FEV₁/FVC ≥ 70%, FEV₁ < 80%) and obstructive spirometry (FEV₁/FVC < 70%). Cox regression was used to estimate the correlation between lung functions and mortality among MI patients. Kaplan-Meier survival curves compared the prognosis of MI with three different lung functions. We further verify the stability of the results by sensitivity analysis.

Results

411 subjects were included in our research. The mean follow-up time for the study was 105 months. Compared with normal spirometry, PRISm was significantly correlated with a greater relative risk for all-cause mortality (adjust HR 3.41, 95% confidence interval [95%CI]: 1.76–6.60, P < 0.001) and cardiovascular mortality (adjust HR 13.9, 95%CI: 2.60–74.6, P = 0.002). PRISm remains more correlated with all-cause mortality (adjust HR 2.73, 95%CI: 1.28–5.83, P = 0.009) relative to obstructive spirometry. The results are basically stable after sensitivity analysis. Kaplan-Meier survival curves showed that patients with PRISm tended to have the lowest survival during the follow-up period.

Conclusion

PRISm is an independent risk factor for all-cause and cardiovascular mortality in MI survivors. The presence of PRISm was associated with a significantly higher risk of all-cause mortality compared with obstructive spirometry.

Available only for authorised users

Puymirat E, Simon T, Cayla G, et al. Acute myocardial infarction: changes in patient characteristics, management, and 6-Month Outcomes over a period of 20 years in the FAST-MI program (French Registry of Acute ST-Elevation or Non-ST-Elevation myocardial infarction) 1995 to 2015. Circulation. 2017;136(20):1908–19. https://doi.org/10.1161/CIRCULATIONAHA.117.030798.CrossRefPubMed

Sin DD, Wu L, Man SFP. The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature. Chest. 2005;127(6):1952–9. https://doi.org/10.1378/chest.127.6.1952.CrossRefPubMed

Engström G, Hedblad B, Janzon L. Reduced lung function predicts increased fatality in future cardiac events. A population-based study. J Intern Med. 2006;260(6):560–7. https://doi.org/10.1111/j.1365-2796.2006.01718.x.CrossRefPubMed

Schwartz A, Arnold N, Skinner B, et al. Preserved ratio impaired spirometry in a spirometry database. Respir Care. 2021;66(1):58–65. https://doi.org/10.4187/respcare.07712.CrossRefPubMedPubMedCentral

Varraso R, Chiuve SE, Fung TT, et al. Alternate healthy eating Index 2010 and risk of chronic obstructive pulmonary disease among US women and men: prospective study. BMJ. 2015;350:h286. https://doi.org/10.1136/bmj.h286.CrossRefPubMedPubMedCentral

Wan ES, Castaldi PJ, Cho MH, et al. Epidemiology, genetics, and subtyping of preserved ratio impaired spirometry (PRISm) in COPDGene. Respir Res. 2014;15:89. https://doi.org/10.1186/s12931-014-0089-y.CrossRefPubMedPubMedCentral

Jankowich M, Elston B, Liu Q, et al. Restrictive spirometry pattern, Cardiac structure and function, and Incident Heart failure in African Americans. The Jackson Heart Study. Ann Am Thorac Soc. 2018;15(10):1186–96. https://doi.org/10.1513/AnnalsATS.201803-184OC.CrossRefPubMedPubMedCentral

Wan ES, Balte P, Schwartz JE, et al. Association between preserved ratio impaired spirometry and clinical outcomes in US adults. JAMA. 2021;326(22):2287–98. https://doi.org/10.1001/jama.2021.20939.CrossRefPubMedPubMedCentral

Washio Y, Sakata S, Fukuyama S, et al. Risks of mortality and airflow limitation in japanese individuals with preserved ratio impaired spirometry. Am J Respir Crit Care Med. 2022;206(5):563–72. https://doi.org/10.1164/rccm.202110-2302OC.CrossRefPubMedPubMedCentral

10.

Wijnant SRA, De Roos E, Kavousi M, et al. Trajectory and mortality of preserved ratio impaired spirometry: the Rotterdam Study. Eur Respir J. 2020;55(1):1901217. https://doi.org/10.1183/13993003.01217-2019.CrossRefPubMed

11.

Higbee DH, Granell R, Davey Smith G, Dodd JW. Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry: a UK Biobank cohort analysis. Lancet Respir Med. 2022;10(2):149–57. https://doi.org/10.1016/S2213-2600(21)00369-6.CrossRefPubMed

12.

Shah CH, Reed RM, Liang Y, Zafari Z. Association between lung function and future risks of diabetes, asthma, myocardial infarction, hypertension and all-cause mortality. ERJ Open Res. 2021;7(3):00178–2021. https://doi.org/10.1183/23120541.00178-2021.CrossRefPubMedPubMedCentral

13.

von Elm E, Altman DG, Egger M, et al. The strengthening the reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–7. https://doi.org/10.1016/S0140-6736(07)61602-X.CrossRef

14.

Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–38. https://doi.org/10.1183/09031936.05.00034805.CrossRefPubMed

15.

Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999;159(1):179–87. https://doi.org/10.1164/ajrccm.159.1.9712108.CrossRefPubMed

16.

Quanjer PH, Stanojevic S, Cole TJ, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40(6):1324–43. https://doi.org/10.1183/09031936.00080312.CrossRefPubMedPubMedCentral

17.

Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12. https://doi.org/10.7326/0003-4819-150-9-200905050-00006.CrossRefPubMedPubMedCentral

18.

Kennel PJ, Kneifati-Hayek J, Bryan J, et al. Prevalence and determinants of hyperpolypharmacy in adults with heart failure: an observational study from the National Health and Nutrition Examination Survey (NHANES). BMC Cardiovasc Disord. 2019;19(1):76. https://doi.org/10.1186/s12872-019-1058-7.CrossRefPubMedPubMedCentral

19.

Fan T, Su D. Interaction effects between sleep disorders and depression on heart failure. BMC Cardiovasc Disord. 2023;23(1):132. https://doi.org/10.1186/s12872-023-03147-5.CrossRefPubMedPubMedCentral

20.

Li J, Covassin N, Bock JM, et al. Excessive daytime sleepiness and Cardiovascular Mortality in US adults: a NHANES 2005–2008 Follow-Up study. Nat Sci Sleep. 2021;13:1049–59. https://doi.org/10.2147/NSS.S319675.CrossRefPubMedPubMedCentral

21.

Maclay JD, MacNee W. Cardiovascular disease in COPD: mechanisms. Chest. 2013;143(3):798–807. https://doi.org/10.1378/chest.12-0938.CrossRefPubMed

22.

Sin DD, Man SFP. Chronic obstructive pulmonary disease: a novel risk factor for cardiovascular disease. Can J Physiol Pharmacol. 2005;83(1):8–13. https://doi.org/10.1139/y04-116.CrossRefPubMed

23.

Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J. 2009;33(5):1165–85. https://doi.org/10.1183/09031936.00128008.CrossRefPubMed

24.

Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340(6):448–54. https://doi.org/10.1056/NEJM199902113400607.CrossRefPubMed

25.

Zhu Y, Xian X, Wang Z, et al. Research Progress on the relationship between atherosclerosis and inflammation. Biomolecules. 2018;8(3):E80. https://doi.org/10.3390/biom8030080.CrossRef

26.

Kaźmierczak M, Ciebiada M, Pękala-Wojciechowska A, Pawłowski M, Nielepkowicz-Goździńska A, Antczak A. Evaluation of markers of inflammation and oxidative stress in COPD patients with or without Cardiovascular Comorbidities. Heart Lung Circ. 2015;24(8):817–23. https://doi.org/10.1016/j.hlc.2015.01.019.CrossRefPubMed

27.

Lind P, Hedblad B, Stavenow L, Janzon L, Eriksson KF, Lindgärde F. Influence of plasma fibrinogen levels on the incidence of myocardial infarction and death is modified by other inflammation-sensitive proteins: a long-term cohort study. Arterioscler Thromb Vasc Biol. 2001;21(3):452–8. https://doi.org/10.1161/01.atv.21.3.452.CrossRefPubMed

28.

Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997;336(14):973–9. https://doi.org/10.1056/NEJM199704033361401.CrossRefPubMed

29.

Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet. 2012;379(9823):1341–51. https://doi.org/10.1016/S0140-6736(11)60968-9.CrossRefPubMedPubMedCentral

30.

Moualla M, Qualls C, Arynchyn A, et al. Rapid decline in lung function is temporally associated with greater metabolically active adiposity in a longitudinal study of healthy adults. Thorax. 2017;72(12):1113–20. https://doi.org/10.1136/thoraxjnl-2016-209125.CrossRefPubMed

31.

Leone N, Courbon D, Thomas F, et al. Lung function impairment and metabolic syndrome: the critical role of abdominal obesity. Am J Respir Crit Care Med. 2009;179(6):509–16. https://doi.org/10.1164/rccm.200807-1195OC.CrossRefPubMed

32.

Johnston AK, Mannino DM, Hagan GW, Davis KJ, Kiri VA. Relationship between lung function impairment and incidence or recurrence of cardiovascular events in a middle-aged cohort. Thorax. 2008;63(7):599–605. https://doi.org/10.1136/thx.2007.088112.CrossRefPubMed

33.

Cuttica MJ, Colangelo LA, Dransfield MT, et al. Lung function in young adults and risk of Cardiovascular events over 29 years: the CARDIA Study. J Am Heart Assoc. 2018;7(24):e010672. https://doi.org/10.1161/JAHA.118.010672.CrossRefPubMedPubMedCentral

34.

Agarwal SK, Heiss G, Barr RG, et al. Airflow obstruction, lung function, and risk of incident heart failure: the atherosclerosis risk in Communities (ARIC) study. Eur J Heart Fail. 2012;14(4):414–22. https://doi.org/10.1093/eurjhf/hfs016.CrossRefPubMedPubMedCentral

35.

Johnson LSB, Juhlin T, Engström G, Nilsson PM. Reduced forced expiratory volume is associated with increased incidence of atrial fibrillation: the Malmo Preventive Project. Europace. 2014;16(2):182–8. https://doi.org/10.1093/europace/eut255.CrossRefPubMed

36.

Ramalho SHR, Shah AM. Lung function and cardiovascular disease: a link. Trends Cardiovasc Med. 2021;31(2):93–8. https://doi.org/10.1016/j.tcm.2019.12.009.CrossRefPubMed

37.

Zaigham S, Johnson L, Wollmer P, Engström G. Measures of low lung function and the prediction of incident COPD events and acute coronary events. Respir Med. 2018;144:68–73. https://doi.org/10.1016/j.rmed.2018.10.007.CrossRefPubMed

38.

Machón M, Arriola L, Larrañaga N, et al. Validity of self-reported prevalent cases of stroke and acute myocardial infarction in the spanish cohort of the EPIC study. J Epidemiol Community Health. 2013;67(1):71–5. https://doi.org/10.1136/jech-2011-200104.CrossRefPubMed

39.

Yamagishi K, Ikeda A, Iso H, Inoue M, Tsugane S, JPHC Study Group. Self-reported stroke and myocardial infarction had adequate sensitivity in a population-based prospective study JPHC (Japan Public Health Center)-based prospective study. J Clin Epidemiol. 2009;62(6):667–73. https://doi.org/10.1016/j.jclinepi.2008.07.016.CrossRefPubMed

40.

Okura Y, Urban LH, Mahoney DW, Jacobsen SJ, Rodeheffer RJ. Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. J Clin Epidemiol. 2004;57(10):1096–103. https://doi.org/10.1016/j.jclinepi.2004.04.005.CrossRefPubMed

41.

Shah NS, Huffman MD, Ning H, Lloyd-Jones DM. Trends in myocardial infarction secondary prevention: the National Health and Nutrition examination surveys (NHANES), 1999–2012. J Am Heart Assoc. 2015;4(4):e001709. https://doi.org/10.1161/JAHA.114.001709.CrossRefPubMedPubMedCentral

42.

Dong W, Yang Z. Association of Dietary Fiber Intake with myocardial infarction and stroke events in US adults: a cross-sectional study of NHANES 2011–2018. Front Nutr. 2022;9:936926. https://doi.org/10.3389/fnut.2022.936926.CrossRefPubMedPubMedCentral

Title: The relationship between preserved ratio impaired spirometry and mortality in the myocardial infarction survivors: a population-based cohort study
Authors: Dan Li
Zhishen Ruan
Shen Xie
Shunchao Xuan
Hengyi Zhao
Bo Wu
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Spirometry
Myocardial Infarction
Published in: BMC Cardiovascular Disorders / Issue 1/2023
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/s12872-023-03352-2

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The relationship between preserved ratio impaired spirometry and mortality in the myocardial infarction survivors: a population-based cohort study

Abstract

Introduction

Methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

Novel combinations of variations in KCNQ1 were associated with patients with long QT syndrome or Jervell and Lange-Nielsen syndrome

Additive effect between homocysteine and low-density-lipoprotein cholesterol upon incidence of novel carotid plaque formation: data from a Chinese community-based cohort

Portuguese adaptation of the Chronic Heart Failure Knowledge Questionnaire (KQCHF)

Relationship between combat-related traumatic injury and its severity to predicted cardiovascular disease risk: ADVANCE cohort study

Chronobiology discrepancies between patients with acute type a aortic dissection complicated with and without sleep apnea syndrome: a single-center seven-year retrospective study

ST-segment elevation predicts the occurrence of malignant ventricular arrhythmia events in patients with acute ST-segment elevation myocardial infarction

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page