Carotid intima‐media thickness in chronic obstructive pulmonary disease and survival: A multicenter prospective study

Abstract

Introduction Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular morbidity and mortality. Carotid intima‐media thickness (CIMT) is a noninvasive method assessing atherosclerosis. Objective It was aimed to determine relationship and survival between COPD and CIMT. Methods CIMT was measured using Doppler ultrasound (USG) in 668 stable COPD patients at 24 centers. Patients were followed‐up for 2 years. Results There were 610 patients who completed the study. There were 200 patients CIMT with <0.78 mm (group 1), and 410 with CIMT ≥ 0.78 mm (group 2). There was a significant difference at the parameters of age, gender, smoking load, biomass exposure, GOLD groups and degree of airway obstruction (FEV1) between groups 1 and 2. Our results revealed positive correlations between mean CIMT and age, smoking load (pack‐years), biomass exposure (years), exacerbation rate (last year), duration of hypertension (years) and cholesterol level; negative correlations between CIMT and FEV1 (P < 0.05). According to logistic regression model, compared with group A, risk of CIMT increase was 2.2‐fold in group B, 9.7‐fold in group C and 4.4‐fold in group D (P < 0.05). Risk of CIMT increase was also related with cholesterol level (P < 0.05). Compared with infrequent exacerbation, it was 2.8‐fold in the patients with frequent exacerbation (P < 0.05). The mean survival time was slightly higher in group 1, but not significant (23.9 vs 21.8 months) (P > 0.05). Conclusion This study is the first regarding CIMT with combined GOLD assessment groups. It has revealed important findings supporting the increase in atherosclerosis risk in COPD patients. We recommend Doppler USG of the carotid artery in COPD patients at severe stages.

Assessment of Subclinical Carotid Atherosclerosis in Patients with Chronic Obstructive Pulmonary Disease

“…Our analysis of Gulbas [19] endorsed our data by showing important variations in the baseline characteristics of groups such as era, smoking load (pack-years), forced vital ability (FVC) (percent), FEV1 (percent), FEV1/FVC and hypertension (years) variables (P < 0,05). There were 200 CIMT <0.78 mm (group 1) and 410 CIMT <0.78 mm (group 1) (group 2).…”

Assessment of incidence of cerebral vascular diseases and prediction of stroke risk in chronic obstructive pulmonary disease patients using multimodal biomarkers

“…A previous study made by Zureik et al also reported a significant relationship between decreased FEV1 levels and endothelial dysfunction and vascular wall stiffness and the presence of atherosclerosis. Additionally, CIMT was found to be significantly associated with GOLD‐combined assessment groups as stated by Gulbas et al Although previous studies reported no relationship between COPD exacerbations and CIMT, it has also been suggested by Golpe et al that the increased systemic inflammatory response during exacerbations may contribute to the activation of an atherosclerotic process 48–51 . Ambrosino et al found that the risk of carotid plaque development was directly correlated with GOLD‐combined assessment groups in COPD patients 52 …”

“…Additionally, CIMT was found to be significantly associated with GOLDcombined assessment groups as stated by Gulbas et al Although previous studies reported no relationship between COPD exacerbations and CIMT, it has also been suggested by Golpe et al that the increased systemic inflammatory response during exacerbations may contribute to the activation of an atherosclerotic process. [48][49][50][51] Ambrosino et al found that the risk of carotid plaque development was directly correlated with GOLD-combined assessment groups in COPD patients. 52 Laboratory investigations revealed a significant elevation of serum inflammatory markers including CRP, fibrinogen, amyloid A, and IL6 in COPD patients than in controls.…”

Comparative Analysis of Arterial Stiffness Between Patients with Chronic Obstructive Pulmonary Disease and Healthy People

“…The occurrence and development of this disease are closely related to abnormal in ammation caused by harmful substances and cardiovascular disease [3,4] . The occurrence of COPD can lead to the decrease of vascular endothelial function, the increase of carotid intima-media thickness, the formation of atherosclerotic plaque and the increase of arterial stiffness, thus increasing the incidence of cardiovascular events [5] . Arterial stiffness is an independent risk factor for evaluating and predicting cardiovascular events.…”