Mechanisms of atherothrombosis in chronic obstructive pulmonary disease

Fimognari, Filippo Luca; Scarlata, Simone; Conte, Maria Elisabetta; Incalzi, Raffaele Antonelli

doi:10.2147/copd.s1401

Cited by 55 publications

(14 citation statements)

References 70 publications

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“…Combined these factors, our study show that the ACOS have an impact on risk of the PE, especially in the patients receiving the high frequency of the healthcare utility [ 29 ]; even in the young adults or [ 30 ] people without comorbidities. In addition, complications such as hypertension [ 24 ], diabetes and cancer [ 31 ] were associated with the atherosclerosis in venous and arterial disease [ 32 , 33 ], which might play a role in the risk of PE [ 4 , 5 ] among the ACOS patients also.…”

Section: Discussionmentioning

confidence: 99%

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Asthma–Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism

2016

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PurposeWe conducted a cohort study to clarify this relationship between asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and pulmonary embolism (PE).MethodsFrom the National Health Insurance Research Database of Taiwan, we identified patients who had a diagnosis of asthma and a diagnosis of COPD (defined as ACOS) and concurrent treatment between January 1999 and December 2009 (ACOS cohort: n = 14,150; non-ACOS cohort: n = 55,876). Cox proportional hazards regression analysis was performed to determine the adjusted hazard ratios (aHRs) for PE of the ACOS cohort compared with the non-ACOS cohort.ResultsComparing the ACOS cohort with the non-ACOS cohort, the aHR of PE was 2.08 (95% confidence intervals [CIs]: 1.56–2.76). The risk of PE was higher in ACOS cohort than non-ACOS cohort, regardless of age, sex, comorbidity, inhaled corticosteroids (ICSs) and oral steroids (OSs) used. For ages ranging from 20 to 65 years, the aHR of PE was 2.53 (95% CI: 1.44–4.44) in the ACOS cohort. ACOS patients using ICSs (aHR: 1.97, 95% CI: 1.29–3.01) or OSs (aHR: 1.97, 95% CI: 1.46–2.65), the risk of PE was higher than in the non-ACOS cohort. The risk of PE increased with the number of outpatient visits and hospitalizations necessitated, ranging from 2.32 (95% CI: 1.54–3.52) in patients having 3–9 visits to 4.20 (95% CI: 2.74–6.44) for those having >9 visits.ConclusionsACOS is associated with increased risk of PE, particularly patients with a high frequency of AE—even in young adults or people without comorbidities.

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Section: Discussionmentioning

confidence: 99%

“…Anti-inflammatory drugs, particularly ICSs [ 33 ], are the mainstay of treatment for asthma or AE of COPD cohort [ 33 ]. ACOS is also a systemic inflammation disease, for which ICSs are usually applied in treatment [ 39 ] The higher frequency of PE among ACOS patients receiving more medical services accords with this finding.…”

Section: Discussionmentioning

confidence: 99%

Asthma–Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism

2016

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“…Mechanisms underlying the association between atherosclerosis and COPD have not been clarified yet. However, chronic systemic inflammation, hypercoagulability, platelet activation, and oxidative stress are the possible important contributors [ 36 , 37 ]. Studies examining the relationship between carotid atherosclerosis and lung function have reported increased IMT in patients with lower FEV 1 [ 38 - 41 ].…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome and carotid intima-media thickness in chronic obstructive pulmonary disease

Alpaydın

Arslan

Serter

et al. 2013

Multidiscip Respir Med

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BackgroundThe aim of this study is to investigate the prevalence of metabolic syndrome (MetS), carotid intima media thickness (IMT), and serum C-reactive protein (CRP) levels in patients with chronic obstructive pulmonary disease (COPD), and the possible relationships among them.MethodsFifty stable COPD patients and 40 healthy controls were included in the study. The participants were further divided into four groups according to their smoking status. Pulmonary function tests were performed in COPD patients. Anthropometric measurements and blood chemistry analysis, serum CRP levels and carotid intima-media thickness (IMT) measurements were performed in all the study population.ResultsPrevalence of metabolic syndrome was 43% in COPD patients and 30% in the control group (p = 0.173). FEV1% and FEV1/FVC were higher in COPD patients with MetS (p = 0.001 and p = 0.014, respectively) compared to those without MetS. Prevalence of MetS was significantly different among the COPD patients with different stages (p = 0.017) with the highest value in stage 2 (59%). Carotid IMT was significantly higher in COPD patients than in control group (1.07 ± 0.25 mm and 0.86 ± 0.18 mm, respectively; p < 0.001). Serum CRP levels were not different in COPD patients and controls, however they were higher in individuals with MetS compared to those without MetS regardless of COPD presence (p = 0.02).ConclusionsEarly markers of atherogenesis, in terms of carotid IMT, were found to be higher in COPD patients than in healthy controls. MetS prevalence was observed to decrease as the severity of airflow obstruction increased. Therefore, screening COPD patients for these cardiovascular risk factors would be a novel approach even in absence of symptoms.

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“…Comorbidities such as congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) have been associated with increased VTE risk in some studies [ 6 - 8 ] but not in others [ 9 , 10 ]. The association with CHF may relate to blood flow stasis which is part of Virchow's triad [ 11 ] of alteration in blood flow (stasis), endothelial injury, and alterations in blood constituents (hypercoagulable factors).…”

Section: Introductionmentioning

confidence: 99%

Risk of venous thromboembolism after total hip and knee replacement in older adults with comorbidity and co-occurring comorbidities in the Nationwide Inpatient Sample (2003-2006)

et al. 2010

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BackgroundVenous thromboembolism is a common, fatal, and costly injury which complicates major surgery in older adults. The American College of Chest Physicians recommends high potency prophylaxis regimens for individuals undergoing total hip or knee replacement (THR or TKR), but surgeons are reluctant to prescribe them due to fear of excess bleeding. Identifying a high risk cohort such as older adults with comorbidities and co-occurring comorbidities who might benefit most from high potency prophylaxis would improve how we currently perform preoperative assessment.MethodsUsing the Nationwide Inpatient Sample, we identified older adults who underwent THR or TKR in the U.S. between 2003 and 2006. Our outcome was VTE, including any pulmonary embolus or deep venous thrombosis. We performed multivariate logistic regression analyses to assess the effects of comorbidities on VTE occurrence. Comorbidities under consideration included coronary artery disease, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, and cerebrovascular disease. We also examined the impact of co-occurring comorbidities on VTE rates.ResultsCHF increased odds of VTE in both the THR cohort (OR = 3.08 95% CI 2.05-4.65) and TKR cohort (OR = 2.47 95% CI 1.95-3.14). COPD led to a 50% increase in odds in the TKR cohort (OR = 1.49 95% CI 1.31-1.70). The data did not support synergistic effect of co-occurring comorbidities with respect to VTE occurrence.ConclusionsOlder adults with CHF undergoing THR or TKR and with COPD undergoing TKR are at increased risk of VTE. If confirmed in other datasets, these older adults may benefit from higher potency prophylaxis.

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Mechanisms of atherothrombosis in chronic obstructive pulmonary disease

Cited by 55 publications

References 70 publications

Asthma–Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism

Asthma–Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism

Metabolic syndrome and carotid intima-media thickness in chronic obstructive pulmonary disease

Risk of venous thromboembolism after total hip and knee replacement in older adults with comorbidity and co-occurring comorbidities in the Nationwide Inpatient Sample (2003-2006)

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