Shared pathways, shared risks: the overlap of interstitial lung abnormalities and coronary heart disease

Idiopathic pulmonary fibrosis (IPF) is a fatal form of interstitial lung disease (ILD) characterised by progressive scarring of the lung parenchyma. Individuals with IPF have more than a three-fold higher risk of acute coronary syndrome compared to the general population, with ischaemic heart disease being the second leading cause of death in IPF [1, 2]. Coronary heart disease (CHD) is significantly more prevalent in IPF than in COPD, despite similar underlying risk factors and patient characteristics [3, 4]. While this strong epidemiological association between CHD and advanced pulmonary fibrosis is well established, the causal relationship and underlying mechanisms linking the two conditions remain poorly understood.