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We evaluated the prevalence of undiagnosed <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content> in patients with <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> and assessed the relationship between airflow obstruction and markers of cardiac stress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We recruited prospectively consecutive patients aged &gt;40 years without known history of chronic lung disease (e.g. asthma, <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>, bronchiectasis) who had undergone percutaneous coronary intervention (<jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>) for obstructive <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> between <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ugust 2009 and <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>ctober 2010. Spirometry was performed and serum <jats:styled-content style=\"fixed-case\">ST2<\/jats:styled-content>, a novel biomarker of cardiomyocyte stress and fibrosis, was measured by enzyme\u2010linked immunosorbent assay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 475 subjects (mean age 64\u2009\u00b1\u20099.7, range 42\u201385 years, 87.2% males, 58.5% current or ex\u2010smokers) who underwent spirometry, 51 (10.7%) had undiagnosed airflow obstruction with <jats:styled-content style=\"fixed-case\">FEV<jats:sub>1<\/jats:sub><\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">FVC<\/jats:styled-content> ratio &lt;70%. Of these 51 subjects, 14 (2.9%), 23 (4.8%) and 14 (2.9%) had <jats:styled-content style=\"fixed-case\">FEV<jats:sub>1<\/jats:sub><\/jats:styled-content> \u226580, 50\u201380 and 30\u201350% predicted normal, respectively. <jats:styled-content style=\"fixed-case\">ST2<\/jats:styled-content> level was measured in all the subjects with undiagnosed airflow obstruction and in 290 subjects with normal lung function. There was no significant difference in left ventricular ejection fraction on echocardiogram between subjects with and without airflow obstruction. Patients with severe airflow obstruction had a higher level of cardiac stress marker <jats:styled-content style=\"fixed-case\">ST2<\/jats:styled-content> than those with mild and moderate airflow obstruction (rho\u2009=\u2009\u22120.214, <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Undiagnosed airflow obstruction is common among patients with <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> who have undergone <jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>. Severity of airflow limitation is associated with increasing cardiac stress.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.12668","type":"journal-article","created":{"date-parts":[[2015,10,29]],"date-time":"2015-10-29T07:54:00Z","timestamp":1446105240000},"page":"137-142","source":"Crossref","is-referenced-by-count":13,"title":["Undiagnosed airflow limitation is common in patients with coronary artery disease and associated with cardiac stress"],"prefix":"10.1111","volume":"21","author":[{"given":"Fanny W.S.","family":"Ko","sequence":"first","affiliation":[{"name":"Division of Respiratory Medicine Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan P.","family":"Yan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yat\u2010yin","family":"Lam","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jojo H.Y.","family":"Chu","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8163-5846","authenticated-orcid":false,"given":"Ka\u2010pang","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S.C.","family":"Hui","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-006-9066-1"},{"key":"e_1_2_6_3_1","unstructured":"World Health Organisation.Cardiovascular diseases 2014. 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