Abstract
BackgroundCardiovascular disease, osteoporosis and emphysema are associated with COPD. Associations between these factors and whether they predict all-cause mortality in COPD patients are not well understood. Therefore, we examined associations between markers of cardiovascular disease (coronary artery calcification [CAC], thoracic aortic calcification [TAC] and arterial stiffness), bone density (bone attenuation of the thoracic vertebrae), emphysema (PI-950 and 15th percentile) and all-cause mortality in a COPD cohort.MethodsWe assessed CAC, TAC, bone attenuation of the thoracic vertebrae, PI-950 and 15th percentile on low-dose chest computed tomography in COPD subjects. We measured arterial stiffness as carotid-radial pulse wave velocity (PWV), and identified deaths from the national register.ResultsWe studied 119 COPD subjects; aged 67.8 ±7.3, 66% were males and mean FEV1% predicted was 46.0 ±17.5. Subjects were classified into three pre-specificed groups: CAC = 0 (n = 14), 0 < CAC ≤ 400 (n = 41) and CAC > 400 (n = 64). Subjects with higher CAC were more likely to be older (p < 0.001) and male (p = 0.03), and more likely to have higher systolic blood pressure (p = 0.001) and a history of hypertension (p = 0.002) or ischemic heart disease (p = 0.003). Higher CAC was associated with higher PWV (OR 1.62, p = 0.04) and lower bone attenuation (OR 0.32, p = 0.02), but not with 15th percentile, after adjustment for age, sex and pack-years of smoking. In a Cox proportional hazards model, CAC, TAC and 15th percentile predicted all-cause mortality (HR 2.01, 2.09 and 0.66, respectively).ConclusionsIncreased CAC was associated with increased arterial stiffness and lower bone density in a COPD cohort. In addition, CAC, TAC and extent of emphysema predicted all-cause mortality.Trial registrationLothian NHS Board, Lothian Research Ethics Committee, LREC/2003/8/28.
Highlights
Cardiovascular disease, osteoporosis and emphysema are associated with Chronic obstructive pulmonary disease (COPD)
Cardiovascular disease and osteoporosis are recognised extrapulmonary manifestations, whose prevalence is higher in COPD patients than in control subjects matched for age and sex [1,2]
Higher Coronary artery calcification (CAC) was associated with higher pulse wave velocity (PWV) and lower bone attenuation, but was not associated with Forced expiratory volume in 1 second (FEV1), 15th percentile and Pixel index (PI)-950 after adjustment for age, sex and pack-years of smoking (Table 2)
Summary
Cardiovascular disease, osteoporosis and emphysema are associated with COPD Associations between these factors and whether they predict all-cause mortality in COPD patients are not well understood. We examined associations between markers of cardiovascular disease (coronary artery calcification [CAC], thoracic aortic calcification [TAC] and arterial stiffness), bone density (bone attenuation of the thoracic vertebrae), emphysema (PI-950 and 15th percentile) and all-cause mortality in a COPD cohort. Sabit and colleagues [5] found that COPD subjects with osteoporosis had increased arterial stiffness, another marker of cardiovascular disease, compared with COPD subjects without osteoporosis. Arterial stiffness and osteoporosis have been shown to relate to the extent of emphysema [6,7] These data suggest associations between cardiovascular disease, osteoporosis and emphysema. COPD related extrapulmonary manifestations are thought to contribute to morbidity and mortality [8]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.