Pulmonary fibrosis and atherosclerosis exhibit histopathological similarities, and fibrotic lung disorders have the potential to influence the vasculature outside the lungs. To investigate whether fibrotic lung disorders might predispose to coronary artery disease (CAD), Kizer et al examined the prevalence of angiographic CAD in 630 patients with advanced lung disease referred for lung transplantation evaluation. Patients with fibrotic lung diseases were more likely to have CAD compared with patients with nonfibrotic lung disorders (adjusted odds ratio, 2.18; 95% confidence interval, 1.17-4.06). The association became stronger when multivessel CAD was examined (adjusted odds ratio, 4.16; 95% confidence interval, 1.46-11.9). Moreover, it was maintained for subgroups having nongranulomatous pulmonary fibrosis and idiopathic pulmonary fibrosis. These findings support the existence of a relationship between fibrotic lung disorders and CAD, but this association will require further study.