Severity of Systemic Calcified Atherosclerosis Is Associated With Airflow Limitation and Emphysema

Chae, Eun Jin; Seo, Joon Beom; Oh, Yeon‐Mok; Lee, Jae Seung; Jung, Young-Ju; Lee, Sang Do

doi:10.1097/rct.0b013e318299f9e7

Cited by 20 publications

(12 citation statements)

References 6 publications

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“…Our study is the first large study to comprehensively investigate the association of COPD with atherosclerotic calcification in different major vessel beds. Previous studies investigating multiple vessel beds in subjects with and without COPD were limited in sample (n = 1154, n = 234 and n = 235) size and did not measure intracranial carotid arteries [10,31,40]. Presence of significant associations in the population-based setting of this study implies a possible stronger link in clinical settings, where COPD is often more severe.…”

Section: Discussionmentioning

confidence: 78%

Atherosclerotic calcification in major vessel beds in chronic obstructive pulmonary disease: The Rotterdam Study

et al. 2019

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Section: Discussionmentioning

confidence: 78%

Atherosclerotic calcification in major vessel beds in chronic obstructive pulmonary disease: The Rotterdam Study

et al. 2019

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“…As mentioned in the introduction section, there is limited information on the relationship between COPD severity and the amount of vascular calcifications. Using multiple logistic regression analysis, Chae et al (29) demonstrated age and FEV1/FVC ratio to be independent predictors of the amount of intrathoracic arterial calcifications (Agatston score >1,000) in 206 subjects diagnosed with (mean FEV1%=53.5) or at risk of COPD. Although the proportional distribution of GOLD stages in this cohort is not reported, the findings of Chae et al (29) are in conformity with our results.…”

Section: Discussionmentioning

confidence: 99%

“…Using multiple logistic regression analysis, Chae et al (29) demonstrated age and FEV1/FVC ratio to be independent predictors of the amount of intrathoracic arterial calcifications (Agatston score >1,000) in 206 subjects diagnosed with (mean FEV1%=53.5) or at risk of COPD. Although the proportional distribution of GOLD stages in this cohort is not reported, the findings of Chae et al (29) are in conformity with our results. By analogy to our study, other risk factors such as smoking history, BMI or diffusing capacity for carbon monoxide (DLCO) were not predictive of thoracic arterial calcifications in their multivariable regression model.…”

Section: Discussionmentioning

confidence: 99%

GOLD stage predicts thoracic aortic calcifications in patients with COPD

et al. 2018

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Although some of the associations between chronic obstructive pulmonary disease (COPD) and atherosclerosis are based on shared risk factors such as smoking, recent epidemiological evidence suggests that COPD is a risk factor for vascular disease due to systemic inflammation. The present study assessed the hypothesis that disease severity (as expressed by the GOLD stage) independently predicts the extent of vascular calcifications. A total of 160 smokers diagnosed with COPD (GOLD I-IV, 40 subjects of each GOLD stage) and 40 smokers at risk (GOLD 0; median age of 60 years old; Q1:56;Q3:65; 135 males and 65 females) underwent non-contrast, non-electrocardiography synchronized chest computerised tomography. The volume of thoracic aortic calcifications was quantified semi-automatically within a region from T1 through T12. Multiparametric associations with GOLD stage, smoking history, sex, age, body mass index and emphysema index were evaluated using generalized linear regression analysis. Thoracic aortic calcifications were highly prevalent in this cohort (187/200 subjects, 709 (Q1:109;Q3:2163) mm 3). Analysis of variance on ranks demonstrated a significant difference in calcium between different GOLD-stages as well as patients at risk of COPD (F=36.8, P<0.001). In the multivariable analysis, GOLD-stages were indicated to be predictive of thoracic aortic calcifications (P≤0.0033) besides age (P<0.0001), while age appeared to be the strongest predictor. Other variables were not statistically linked to thoracic aortic calcifications in the multivariable model. COPD severity, as expressed by the GOLD-stage, is a significant predictor of thoracic aortic calcifications, independent of covariates such as age or tobacco consumption.

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“…The Mesa study also found that FEV 1 was associated with the extent of distal aortic calcification (0.76; 95%CI 0.60–0.97, p =0.02) but not proximal aortic calcification (21). A study by Chae et al found that the amount of vascular calcification was associated with the extent of emphysema on computed tomography and airflow limitation (22). This is in contrast with a recent study from China on elderly smokers with airflow limitation that found no evidence that the association of pulmonary function with CIMT varied by smoking status (23).…”

Section: Discussionmentioning

confidence: 99%

Airflow obstruction, atherosclerosis and cardiovascular risk factors in the AGES Reykjavik study

et al. 2016

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Background and aims Airflow limitation, i.e. reduced forced expiratory volume in one-second (FEV1) is associated with increased prevalence of atherosclerosis, however, causal mechanisms remain elusive. The objective of the study was to determine if the association between airflow obstruction and markers of atherosclerosis were mediated by systemic inflammation. Methods 1154 subjects from the longitudinal AGES Reykjavik study were included. Population characteristics, systemic inflammation markers from blood (white blood cell counts (WBC) and level of C-reactive protein (CRP)) were compared between patients with and without airflow limitation defined by reduced FEV1 on spirometry. Atherosclerosis burden was quantified by measurements of coronary artery calcium, aortic arch and distal aortic calcification in addition to carotid intimal media thickness (CIMT). Results Subjects were split into four groups according to smoking status and if airflow limitation was present. There was a higher overall burden of atherosclerosis in ever-smokers compared to never-smokers, and in individuals with airflow obstruction compared to individuals without airflow obstruction. After adjusting for population characteristics, Framingham cardiovascular risk factors and markers of systemic inflammation (WBC and CRP), there was a significantly more aortic arch and distal aorta calcification and higher measurement of CIMT for individuals with airflow obstruction compared to individuals without airflow obstruction. After adjusting for population characteristics, Framingham cardiovascular risk factors and markers of systemic inflammation (WBC and CRP), there was a significantly more aortic arch and distal aorta calcification and higher measurement of CIMT for individuals with airflow obstruction compared to individuals without airflow obstruction. Conclusions Systemic inflammation (WBC and CRP) does not appear to mediate the association between airflow limitation and atherosclerosis. Only airflow limitation and not systemic inflammation (WBC and CRP) appears to be an independent predictor of atherosclerosis.

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Severity of Systemic Calcified Atherosclerosis Is Associated With Airflow Limitation and Emphysema

Abstract: The amount of calcification was associated with the extent of emphysema on computed tomography and airflow limitation.

Cited by 20 publications

References 6 publications

Atherosclerotic calcification in major vessel beds in chronic obstructive pulmonary disease: The Rotterdam Study

Atherosclerotic calcification in major vessel beds in chronic obstructive pulmonary disease: The Rotterdam Study

GOLD stage predicts thoracic aortic calcifications in patients with COPD

Airflow obstruction, atherosclerosis and cardiovascular risk factors in the AGES Reykjavik study

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