Association between carotid intima-media thickness and presence of coronary artery disease in chronic obstructive pulmonary disease patients

Abstract

Objective:Chronic obstructive pulmonary disease (COPD) is a risk factor for cardiovascular disease (CVD). Carotid intima-media thickness (CIMT) is the sign of subclinical atherosclerosis. Therefore, the aim of this study was to evaluate whether CIMT measurement is related with significant coronary artery disease (CAD) in patients with COPD, similar to those without COPD.Methods:One hundred and eight patients with previously diagnosed COPD and 78 patients without COPD who underwent coronary angiography (CAG) were enrolled in this prospective cross-sectional study. Carotid artery ultrasonography was performed on all patients after coronary angiography by another operator who was blind to the CAG results. The patients were divided into four subgroups as follows: group 1: COPD (-) and CAD (-); group 2: COPD (-) and CAD (+); group 3: COPD (+) and CAD (+); and group 4: COPD (+) and CAD (-). Patients with previous coronary revascularization, carotid artery disease, and lung disease other than COPD were not enrolled in this study. The student’s t-test, chi-square analysis, multiple logistic regression analysis, and receiver operating characteristic (ROC) curve were used for statistical analysis.Results:CIMT was found to be highest in patients with both significant CAD and COPD (group 3) (p<0.05). Among the 108 COPD patients, the odds ratio associated with the CIMT >1.25 mm to predict CAD was 12.4. The area under the ROC curve for a cut-off value of 1.25 mm for CIMT to predict CAD in COPD patients was calculated as 0.913, with a sensitivity of 89.7% and specificity of 86.7%.Conclusion:CIMT has a predictive value for the presence of CAD in patients with COPD. Further studies are needed to validate our results. (Anatol J Cardiol 2016; 16: 601-7)

Comment on “Comparison of arterial stiffness and ultrasound indices in patients with and without chronic obstructive pulmonary disease”

“…Obviously, the longer the duration of COPD, the higher the level of arterial stiffness in COPD patients. This hypothesis has also been clarified by previous studies 2, 3 . In addition, information about drug therapy strategies and lung function in COPD patients is unknown.…”

Subclinical atherosclerosis risk markers in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

“…In 9 studies [19,23,25,26,34,35,37,42,43], we found a significantly higher CIMT in 726 COPD patients than in 2130 controls (MD: 0.10 mm; 95% CI: 0.04, 0.16; p ¼ 0.0007, Fig. 1A), with high detected heterogeneity (I 2 ¼ 94%, p < 0.0001).…”

“…CIMT [19,25,26,34,37,42 and collagen replacement in the extracellular matrix, which result in emphysema in the lungs, and give rise to increased arterial stiffness in the vascular system, have been found in COPD, especially for emphysematous phenotype. Last, COPD might accelerate aging, which facilitates the premature occurrence of systemic complications, such as hypertension, glycemia and cholesterolemia etc [4].…”

Role of N Terminal-Pro Brain Natriuretic Peptide in predicting the Severity of Coronary Artery Disease in Patients with Chronic Stable Angina

“…Some studies have also shown that non invasive CIMT measurement might be substitute of invasive angiographic assessment of coronary artery. [14][15][16][17][18][19] Conclusion Although majority studies over a long period of time showed correlation between CIMT and severity of CAD but one study found that severity of CAD did not correlate with CIMT. Risk factors like diabetes, hypertension could be related to increased CIMT.…”