Burden of Cardiovascular Disease in Chronic Obstructive Pulmonary Disease

Agarwal, Shikhar; Rokadia, Haala; Senn, Todd; Menon, Venu

doi:10.1016/j.amepre.2014.03.014

Cited by 20 publications

(14 citation statements)

References 35 publications

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“…More importantly, non-cardiovascular diseases account for significant proportion of deaths in CKD and we report four fold higher risk for respiratory deaths among those with COPD and CKD. Using data collected in NHANES 2007–2010, Agarwal et al, reported higher prevalence of self-reported cardiovascular disease in subjects with COPD than in those without COPD(2). Further, among those without previous cardiovascular disease, the risk of future cardiovascular disease was significantly higher in the COPD group than in the non-COPD group.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic kidney disease (CKD) is also an emerging public health issue around the globe. The prevalence of both CKD and COPD increases with age and both these diseases are associated with atherosclerotic disease(2, 3). While the mechanisms linking CKD and COPD have not been completed elucidated, systemic inflammation and hypoxia associated with COPD could contribute to adverse outcomes in those with CKD(4).…”

Section: Introductionmentioning

confidence: 99%

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Mortality Outcomes of Patients with Chronic Kidney Disease and Chronic Obstructive Pulmonary Disease

et al. 2016

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Background: Chronic obstructive pulmonary disease (COPD) is associated with higher mortality in the general population. We studied the associations between COPD and death among chronic kidney disease (CKD) patients along with reporting cause-specific death data. Methods: We included 56,960 patients with stages 3 and 4 CKD who were followed in a large health care system. Associations between COPD and all-cause mortality and various causes of death (respiratory deaths, cardiovascular deaths, malignancy-related deaths and deaths due to other reasons) were studied using the Cox proportional hazards and competing risk models. Results: Out of 56,960 CKD patients, 4.7% (n = 2,667) had underlying COPD. Old age, presence of diabetes, hypertension, coronary artery disease, congestive heart failure, and smoking were associated with higher risk for COPD. During a median follow-up of 3.7 years, 15,969 patients died. After covariate adjustment, COPD was associated with a 41% increased risk (95% CI 1.31-1.52) for all-cause mortality, and fourfold increased risk (sub-hazard ratio 4.36, 95% CI 3.54-5.37) for respiratory-related deaths. In a sensitivity analysis that was performed by defining COPD as the use of relevant International Classification of Diseases-9 codes and medications used to treat COPD, similar results were noted. Conclusions: COPD is associated with higher risk for death among those with CKD, and an underlying lung disease accounts for significant proportion of deaths. These data highlight the need for further prospective studies to understand the underlying mechanisms and potential interventions to improve outcomes in this population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mortality Outcomes of Patients with Chronic Kidney Disease and Chronic Obstructive Pulmonary Disease

et al. 2016

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“…CB is associated with multiple clinical consequences, including a hastened decline in lung function, an increased risk of exacerbation and possibly raised all-cause mortality. Recent researches have indicated that CB is a systemic disease with manifestations such as inflammation, weight loss, skeletal muscle dysfunction (Agusti et al, 2003;Oudijk et al, 2003) and cardiovascular disease (Agarwal et al, 2014). The primary factors that cause CB are genetic susceptibility and environment impacts (Bahr et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

LC‐MS based metabolomics identification of novel biomarkers of tobacco smoke‐induced chronic bronchitis

Ren

Zhang

et al. 2015

Biomedical Chromatography

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Tobacco smoke (TS) is a major causative agent to lead to chronic bronchitis (CB). However the mechanisms of CB induced by TS are unclear. In this report, rats were exposed to different concentrations of TS and the metabolic features of CB were characterized by using a nontargeted metabolic profiling method based on liquid chromatography-mass spectrometry (LC-MS) to detect the altered metabolic patterns in serum from CB rats and investigate the mechanisms of CB. 11 potential biomarkers were identified in serum of rats. Among them, the levels of lysophosphatidylethanolamine (18:1), lysophosphatidic acid (18:1), lysophosphatidylethanolamine (18:0), lysophosphatidylethanolamine (16:0), lysophosphatidylethanolamine (20:4), docosahexaenoic acid, 5-hydroxyindoleacetic acid and 5'-carboxy-γ-tocopherol were higher in TS group compared to control group. Conversely, the levels of 4-imidazolone-5-propionic acid, 12-hydroxyeicosatetraenoic acid and uridine were lower in TS group. The results indicated that the mechanism of CB was related to amino acid metabolism and lipid metabolism, particularly lipid metabolism. In addition, lysophosphatidylethanolamines were proved to be important mediators, which could be used as biomarkers to diagnose CB. These results also suggested that metabolomics was suitable for diagnosing CB and elucidating the possible metabolic pathways of TS-induced CB.

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“…In the National Health and Nutrition Examination Survey (NHANES) database the estimated self-reported cardiovascular disease prevalence was 20.0% and 7.4% in COPD and non-COPD groups, respectively (19). In multivariable analysis, COPD was an independent risk factor for self-reported cardiovascular disease.…”

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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Burden of Cardiovascular Disease in Chronic Obstructive Pulmonary Disease

Cited by 20 publications

References 35 publications

Mortality Outcomes of Patients with Chronic Kidney Disease and Chronic Obstructive Pulmonary Disease

Mortality Outcomes of Patients with Chronic Kidney Disease and Chronic Obstructive Pulmonary Disease

LC‐MS based metabolomics identification of novel biomarkers of tobacco smoke‐induced chronic bronchitis

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

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