Prevalence and clinical impacts of coronary artery disease in patients with interstitial lung disease

<bold>Introduction:</bold> Several studies reported high prevalence of coronary artery disease (CAD) in patients with interstitial lung disease (ILD). However, there are only limited data related to the prevalence and clinical significance of CAD in ILD patients, especially in Asia. <bold>Method:</bold> We retrospectively reviewed electronic medical records of patients with ILD, who underwent coronary computed tomography (CT) at Asan Medical Center in South Korea from 2010 to 2023. We investigated the proportion of patients who received coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). Additionally, PCI related factors were also analyzed by using Logistic regression model. <bold>Results:</bold> A total of 164 patients were included in this study, with a mean age of 66 years; 67.1% were male, and 61% were ever-smokers. Coronary CT was conducted for reasons such as incidental coronary artery calcification findings on chest CT (51.8%), work up before lung transplantation (25.6%), CAD related symptoms (11.6%) and others (11.0%). Coronary Artery Disease–Reporting and Data System (CAD-RADS) scores were 0 in 31 cases (18.9%), 1 in 15 cases (9.1%), 2 in 47 cases (28.7%), 3 in 16 cases (9.8%), 4 in 51 cases (31.1%), and 5 in 4 cases (2.4%). Forty patients (24.4%) underwent CAG, and 21 patients (12.8%) were received PCI. In the multivariate logistic analysis, age (adjusted OR=1.09, 95% CI 1.03-1.16, <italic>P</italic> value=0.003) and abnormal ECG (adjusted OR 3.22, 95% CI 1.09-9.55, <italic>P</italic> value=0.035) were significantly associated with PCI after adjusting diabetes mellitus. <bold>Discussion:</bold> This study suggests that clinicians might consider the need of PCI in ILD patients with CAD especially in old age or with abnormal ECG.