Study hypotheses 1. Spirometry screening after acute coronary syndrom (ACS) will reveal that the majority of subjects with chronic obstructive pulmonary disease (COPD) are undiagnosed. 2. Spirometry-verified COPD is an independent predictor of death, reinfarction and stroke in subjects with Acute Coronary Syndrome (ACS).
Setting and participants 1. All patients living in the county of Jämtland, Sweden, and hospitalised with a diagnosis of myocardial infarction or unstable angina will be assessed for inclusion. 2. Östersund hospital is the only hospital in the county and all patients, terminal care excluded, with symptoms of a suspected acute coronary syndrome are referred for diagnostic evaluation. 3. Study subjects are recruited in conjunction with the study "Secondary preventive, nurse based, telephone follow-up for risk factor control after an acute coronary syndrome" (www.controlled-trials.com/ISRCTN96595458/)
Methods The study subjects will be screened with spirometry to detect presence of chronic airflow limitation. Lung volume measurements (spirometry) will be done during the hospitalisation or at the first follow-up out-patient visit after discharge. Vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) will be measured before and after bronchodilation. FEV1/FVC <0.7 post bronchodilation will be considered as copd.>
The prevalence of spirometry-detected COPD will be compared with the prevalence of COPD based on medical records in the study population. We will evaluate whether spirometry-verified COPD predicts prognosis after ACS. Inclusion between 01 January 2010 and 30 June 2012, follow-up until 31 December 2015.