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Firincioglulari A, Erturk H, Firincioglulari M, Biber C. Evaluation of atherosclerosis as a risk factor in COPD patients by measuring the carotid intima-media thickness. Cardiovasc Ultrasound 2024; 22:2. [PMID: 38195448 PMCID: PMC10777512 DOI: 10.1186/s12947-023-00322-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/31/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND This study aimed to evaluate atherosclerosis as comorbidity by measuring the carotid (bulb and common carotid artery) Carotid intima-media thickness in COPD-diagnosed patients and to evaluate the relationship of atherosclerosis with the prevalence of COPD, hypoxemia and hypercapnia. METHODS This study was conducted out between January 2019-December 2019 consisting of a total of 140 participants (70 COPD-diagnosed patients-70 healthy individuals). The COPD-diagnosed patients have been planned according to the selection and diagnosis criteria as per the GOLD 2019 guide. It is planned to evaluate as per prospective matching case-control study of the carotid thickness, radial gas analysis, spirometric and demographic characteristics of COPD diagnosed patients and healthy individuals. RESULTS The average Carotid intima-media thickness in COPD patients was 0.8746±0.161 (p<0.05), and the thickness of the carotid bulb was 1.04±0.150 (p<0.05). In the control group, the average CCA intima-media thickness was 0.6650±0.139 (p<0.05), and the thickness of the carotid bulb was 0.8250±0.15(p<0.05) For the carotid thickness that has increased in COPD diagnosed patients a significant relationship is determined between hypoxemia (p<0.05) and hypercapnia(p<0.05). A significant relationship determined between CIMT and severity of COPD (p<0.05) The CIMT was high in COPD patients with hypoxemia and hypercapnia(p<0.05). CONCLUSION Significant difference was determined between the severity (grades) of COPD (mild, moderate, severe, very severe) in carotid thickness. Also, CIMT was found to be high in patients who is in the early phases of the prevalence of COPD. In COPD-diagnosed patients, it was determined that severity of COPD, hypoxemia, hypercapnia and age were determining factors of atherosclerosis.
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Affiliation(s)
- Ali Firincioglulari
- Department of Chest Diseases, Dr Burhan Nalbantoğlu State Hospital, Nicosia, Cyprus
| | - Hakan Erturk
- Department of Radiology, Health Sciences University, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | - Mujgan Firincioglulari
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Cyprus International University, Nicosia, Cyprus.
| | - Cigdem Biber
- Department of Chest Diseases, Health Sciences University, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara, Turkey
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Badr MY, Elkholy AA, Shoeib SM, Bahey MG, Mohamed EA, Reda AM. Assessment of incidence of cerebral vascular diseases and prediction of stroke risk in chronic obstructive pulmonary disease patients using multimodal biomarkers. Clin Respir J 2023; 17:211-228. [PMID: 36696969 PMCID: PMC9978912 DOI: 10.1111/crj.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/31/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Early assessment of cerebrovascular disease in chronic obstructive pulmonary disease (COPD) patients is an important issue for a favorable influence on the quality of life. METHODOLOGY This cross-sectional case-control study was conducted on 38 eligible COPD patients (mean age 55.5 ± 11.5, 25 males, and 13 females) and 26 age-/sex-matched healthy controls. All participants were subjected to stroke risk screening instruments that included the Stroke Riskometer™, the Framingham 10-Year Risk Score, the stroke risk screening tool (the Department of Disease Control of Thailand), the My Risk Stroke Calculator, and Q Stroke. Radiologically, diffusion tensor imaging (DTI) and echo-gradient MRI (T2 star) T2 star imaging were done. Color-coded duplex sonography was done. Laboratory investigations included C-reactive protein (CRP), serum amyloid A, plasma fibrinogen level, serum IL6, 8-Isoprostane, vWF and urinary albumin creatinine ratio. RESULTS Stroke risk screening instruments revealed a significant increase in COPD patients. DTI showed a significant bilateral reduction in fractional isotropy and a significant bilateral increase in mean diffusivity of white matter through many areas in COPD patients. Patients also had a significant increase of intima-media thickness, presence of atherosclerotic focal thicknesses or plaques on duplex sonography. There was a significant elevation of CRP, serum amyloid A, plasma fibrinogen level, serum IL6, 8-isoprostane, von Willebrand factor (vWF), and urinary albumin creatinine ratio in COPD patients. CONCLUSION COPD patients had an increased risk for stroke that could be assessed on stroke risk screening instruments, DTI, T2 star, duplex sonography, and laboratory investigation and could be correlated with the severity of the disease.
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Affiliation(s)
- Marwa Y Badr
- Neurology unit, Neuropsychiatry Department, Faculty of Medicine, Tanta University, Egypt
| | - Amira A Elkholy
- Pulmonology Department, Faculty of Medicine, Tanta University, Egypt
| | - Sara M Shoeib
- Clinical Pathology Department, Faculty of Medicine, Tanta University, Egypt
| | - Marwa G Bahey
- Medical Microbiology and immunology Department, Faculty of Medicine, Tanta University, Egypt
| | - Esraa A Mohamed
- Medical Microbiology and immunology Department, Faculty of Medicine, Tanta University, Egypt
| | - Alaa M Reda
- Diagnostic Radiology Department, Faculty of Medicine, Tanta University, Egypt
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Lee B, Kim KS, Shim JK, Kim HB, Jun B, Kwak YL. Increased Carotid Intima-Media Thickness was not Associated With Cognitive Dysfunction After Off-Pump Coronary Surgery in Older Adult Patients Without Carotid Stenosis. Semin Thorac Cardiovasc Surg 2021; 34:112-121. [PMID: 33711464 DOI: 10.1053/j.semtcvs.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/04/2021] [Indexed: 12/18/2022]
Abstract
Increased carotid intima-media thickness (C-IMT), a marker of atherosclerosis, is known to be associated with cerebrovascular and cortical abnormalities and cognitive impairment. This prospective observational study investigated the association between increased C-IMT and postoperative cognitive dysfunction (POCD) in older adult patients undergoing off-pump coronary artery bypass surgery. A total of 201 patients (57 females, 144 males; >60 years) were classified into increased (n = 105) or normal (n = 96) C-IMT groups by a cut-off value of 0.9 mm (bilateral C-IMT mean). Cognitive function was serially assessed with the Korean Mini-Mental State Examination, and Korean Montreal Cognitive Assessment scores preoperatively and at 7 days and 3 months postoperatively. POCD was defined as the deterioration of 1 standard deviation in at least one of the postoperative tests compared with their corresponding baseline scores. Independent risk factors for POCD were evaluated using multivariable analysis. Overall, POCD occurred in 46 patients (23%) over the 3 months. The incidences of POCD at 7 days and 3 months after surgery were similar, and there was no difference in both Korean Mini-Mental State Examination and Korean Montreal Cognitive Assessment test scores before and after surgery between groups. Chronic obstructive lung disease and intraoperative hyperglycemia episodes (>180 mg/dL), but not increased C-IMT, were independent risk factors for POCD. Unlike in nonsurgical cohorts, increased C-IMT was not significantly associated with the occurrence of POCD in older adult patients undergoing off-pump coronary artery bypass surgery.
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Affiliation(s)
- Bora Lee
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kwang-Sup Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Jae-Kwang Shim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Hye-Bin Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Byongnam Jun
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Lan Kwak
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea.
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Elrefai AW, Alsayyad MM, Dawood EMAEHH. Pulmonary emphysema and atherosclerosis: association or syndrome? Egypt J Radiol Nucl Med 2020. [DOI: 10.1186/s43055-020-00319-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Atherosclerosis is an inflammatory reaction of the vessel wall. Emphysema may induce systemic inflammation, part of which may be the development or progression of atherosclerosis. So, the relationship between emphysema and atherosclerosis, whether both are due to the same causative agent and pathogenesis or emphysema led to atherosclerosis, is still not clearly understood. So, the aim of this work is to study the relationship between carotid atherosclerosis versus pulmonary emphysema extent and airflow obstruction.
Results
Cigarette smoking index was higher in patients than controls. According to FEV1%, patients were classified into: GOLD 1 (mild): FEV1 ≥ 80% predicted, GOLD 2 (moderate): 50% ≤ FEV1 < 80% predicted, GOLD 3 (severe):30% ≤ FEV1 < 50% predicted, and GOLD 4 (very severe): FEV1 < 30% predicted. There was a significant difference between the studied groups as regard to ABG parameters. Emphysema score showed a positive correlation with thrombus size, plaque size, and stenosis percent. Approximately 2/3 of patients had atherosclerotic changes and the other 1/3 had increased IMT. GOLD staging, also, correlated with thrombus size and stenosis percent. So, there was a strong positive correlation between both emphysema score and GOLD staging and carotid atherosclerosis.
Conclusion
The relationship between emphysema and atherosclerosis is suggested to be the chronic inflammatory reaction (against the same risk factor) based on the positive correlation between carotid atherosclerosis versus emphysema score and GOLD staging. The inherence of emphysema and atherosclerosis may be considered a syndrome. If so, targeting the same pathogenic mechanism will be valuable for their control.
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Buklioska-Ilievska D, Minov J, Kochovska-Kamchevska N, Gigovska I, Doneva A, Baloski M. Carotid Artery Disease and Lower Extremities Artery Disease in Patients with Chronic Obstructive Pulmonary Disease. Open Access Maced J Med Sci 2019; 7:2102-2107. [PMID: 31456833 PMCID: PMC6698108 DOI: 10.3889/oamjms.2019.576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 11/05/2022] Open
Abstract
AIM To assess the frequency of carotid artery disease (CAD) and lower extremities artery disease (LEAD) in patients with chronic obstructive pulmonary disease (COPD) and their relation to the severity of airflow limitation and the level of C-reactive protein (CRP). METHODS We performed a cross-sectional study including 60 patients with COPD (52 male, 8 female), aged 40 to 80 years, initially diagnosed according to the actual criteria. Also, 30 subjects in whom COPD was excluded, matched to COPD patients by sex, age, body mass index and smoking status, served as controls. All study subjects completed questionnaire and underwent pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, and chest X-ray), angiological evaluation by Doppler ultrasonography and measurement of serum CRP level. RESULTS We found a statistically significant difference between the frequency of carotid plaques in COPD patients as compared to their frequency in controls (65% vs 30%; P = 0.002). The mean value of intima-media thickness (IMT) in COPD patients with CAD was significantly higher than its mean value in controls (0.8 ± 0.2 vs. 0.7 ± 0.2; P = 0.049). IMT value in COPD patients with CAD was significantly related to the degree of airflow limitation, i.e. to the degree of FEV1 decline (P = 0.000), as well as to the serum CRP level (P = 0.001). We found a statistically significant difference between the frequency of COPD patients with LEAD as compared to the frequency of LEAD in controls (78.3% vs 43.3%; P = 0.001). According to the Fontaine classification, COPD patients with LEAD were categorized in the stages I, IIA and IIB (53.3%, 30% and 16.7%, respectively), whereas all controls with LEAD were categorized in the Fontaine stage I. Among COPD patients with LEAD there was significant association between disease severity and clinical manifestations due to the vascular changes (P = 0.001) and serum CRP level (P = 0.001). CONCLUSION Our findings suggest higher prevalence and higher severity of vascular changes in COPD patients as compared to their prevalence and severity in non-COPD subjects. Prevalence and severity of vascular changes in COPD patients were significantly related to the severity of airflow limitation and serum CRP levels.
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Affiliation(s)
- Daniela Buklioska-Ilievska
- Department of Pulmonology and Allergology, General Hospital "8th September", Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Jordan Minov
- Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.,Institute for Occupational Health of Republic of Macedonia - WHO Collaborating Center, Skopje, Republic of Macedonia
| | - Nade Kochovska-Kamchevska
- Department of Pulmonology and Allergology, General Hospital "8th September", Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Irena Gigovska
- Department of Cardiology, General Hospital "8th September", Skopje, Republic of Macedonia
| | - Ana Doneva
- Neurology, General Hospital "8th September", Skopje, Republic of Macedonia
| | - Marjan Baloski
- Department of Pulmonology and Allergology, General Hospital "8th September", Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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Gulbas G, Turan O, Sarioglu N, Diken OE, Ogan N, Ekbic Kadioglu E, Kurtipek E, Bozkus F, Yilmaz Demirci N, Coskun Beyan A, Mutlu LC, Sahin Duyar S, Deniz S, Fazlioglu N, Sengul A, Tanriverdi H, Okutan O, Turan PA, İnonu H, Ortakoylu MG, Lakadamyali H, Kivanc T, Atli O, Özdemir O, Filiz Koşar A, Mirici A, Suerdem M. Carotid intima-media thickness in chronic obstructive pulmonary disease and survival: A multicenter prospective study. Clin Respir J 2019; 13:391-399. [PMID: 30942958 DOI: 10.1111/crj.13024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/19/2019] [Accepted: 03/24/2019] [Indexed: 11/27/2022]
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.
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Affiliation(s)
- Gazi Gulbas
- Department of Pulmonary Medicine, Turgut Ozal Research Center, Inonu University, Malatya, Turkey
| | - Onur Turan
- Department of Pulmonary Medicine, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Nurhan Sarioglu
- Department of Pulmonary Medicine, Balikesir University, Balikesir, Turkey
| | | | - Nalan Ogan
- Department of Pulmonary Medicine, Ufuk University, Ankara, Turkey
| | - Esra Ekbic Kadioglu
- Department of Pulmonary Medicine, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Ercan Kurtipek
- Department of Pulmonary Medicine, Konya Training and Research Hospital, Konya, Turkey
| | - Fulsen Bozkus
- Department of Pulmonary Medicine, Sutcu Imam University, K. Maras, Turkey
| | | | - Ayşe Coskun Beyan
- Department of Pulmonary Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Levent Cem Mutlu
- Department of Pulmonary Medicine, Namik Kemal University, Tekirdag, Turkey
| | - Sezgi Sahin Duyar
- Department of Pulmonary Medicine, Beypazari State Hospital, Ankara, Turkey
| | - Sami Deniz
- Department of Pulmonary Medicine, Didim State Hospital, Mugla, Turkey
| | - Nevin Fazlioglu
- Department of Pulmonary Medicine, Acibadem Hospital, Kayseri, Turkey
| | - Aysun Sengul
- Derince Training and Research Hospital, Kocaeli, Turkey
| | - Hakan Tanriverdi
- Department of Pulmonary Medicine, Bulent Ecevit University, Zonguldak, Turkey
| | - Oğuzhan Okutan
- Department of Pulmonary Medicine, GATA, Training and Research Hospital, Istanbul
| | - Pakize Ayse Turan
- Department of Pulmonary Medicine, Menemen State Hospital, Izmir, Turkey
| | - Handan İnonu
- Department of Pulmonary Medicine, Gazi Osman Pasa University, Tokat, Turkey
| | | | | | - Tulay Kivanc
- Department of Pulmonary Medicine, Baskent University, Konya, Turkey
| | - Ozgur Atli
- Department of Pulmonary Medicine, Diyarbakir State Hospital, Diyarbakir, Turkey
| | | | - A Filiz Koşar
- Department of Pulmonary Medicine, Saglik Bilimleri University, Istanbul, Turkey
| | - Arzu Mirici
- Department of Pulmonary Medicine, 18 Mart University, Canakkale, Turkey
| | - Mecit Suerdem
- Department of Pulmonary Medicine, Selcuk University, Konya, Turkey
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Bhatt SP, Nath HP, Kim YI, Ramachandran R, Watts JR, Terry NLJ, Sonavane S, Deshmane SP, Woodruff PG, Oelsner EC, Bodduluri S, Han MK, Labaki WW, Michael Wells J, Martinez FJ, Barr RG, Dransfield MT. Centrilobular emphysema and coronary artery calcification: mediation analysis in the SPIROMICS cohort. Respir Res 2018; 19:257. [PMID: 30563576 PMCID: PMC6299495 DOI: 10.1186/s12931-018-0946-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/20/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is associated with a two-to-five fold increase in the risk of coronary artery disease independent of shared risk factors. This association is hypothesized to be mediated by systemic inflammation but this link has not been established. METHODS We included 300 participants enrolled in the SPIROMICS cohort, 75 each of lifetime non-smokers, smokers without airflow obstruction, mild-moderate COPD, and severe-very severe COPD. We quantified emphysema and airway disease on computed tomography, characterized visual emphysema subtypes (centrilobular and paraseptal) and airway disease, and used the Weston visual score to quantify coronary artery calcification (CAC). We used the Sobel test to determine whether markers of systemic inflammation mediated a link between spirometric and radiographic features of COPD and CAC. RESULTS FEV1/FVC but not quantitative emphysema or airway wall thickening was associated with CAC (p = 0.036), after adjustment for demographics, diabetes mellitus, hypertension, statin use, and CT scanner type. To explain this discordance, we examined visual subtypes of emphysema and airway disease, and found that centrilobular emphysema but not paraseptal emphysema or bronchial thickening was independently associated with CAC (p = 0.019). MMP3, VCAM1, CXCL5 and CXCL9 mediated 8, 8, 7 and 16% of the association between FEV1/FVC and CAC, respectively. Similar biomarkers partially mediated the association between centrilobular emphysema and CAC. CONCLUSIONS The association between airflow obstruction and coronary calcification is driven primarily by the centrilobular subtype of emphysema, and is linked through bioactive molecules implicated in the pathogenesis of atherosclerosis. TRIAL REGISTRATION ClinicalTrials.gov: Identifier: NCT01969344 .
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Affiliation(s)
- Surya P Bhatt
- Division of Pulmonary, Allergy and Critical Care Medicine and Lung Health Center, University of Alabama at Birmingham, THT 422, 1720, 2nd Avenue South, Birmingham, AL, 35294, USA.
- UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
| | - Hrudaya P Nath
- UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Young-Il Kim
- Division of Pulmonary, Allergy and Critical Care Medicine and Lung Health Center, University of Alabama at Birmingham, THT 422, 1720, 2nd Avenue South, Birmingham, AL, 35294, USA
- Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Rekha Ramachandran
- Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Jubal R Watts
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Nina L J Terry
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Sushil Sonavane
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Swati P Deshmane
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Prescott G Woodruff
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University California San Francisco, San Francisco, CA, 94143, USA
| | - Elizabeth C Oelsner
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Medical Center, New York, NY, 10032, USA
| | - Sandeep Bodduluri
- Division of Pulmonary, Allergy and Critical Care Medicine and Lung Health Center, University of Alabama at Birmingham, THT 422, 1720, 2nd Avenue South, Birmingham, AL, 35294, USA
- UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Wassim W Labaki
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
| | - J Michael Wells
- Division of Pulmonary, Allergy and Critical Care Medicine and Lung Health Center, University of Alabama at Birmingham, THT 422, 1720, 2nd Avenue South, Birmingham, AL, 35294, USA
- UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
- Birmingham Veterans Affairs Hospital, Birmingham, AL, 35294, USA
| | - Fernando J Martinez
- Division of Pulmonary and Critical Care Medicine, Weill Cornell School of Medicine, New York, NY, 10065, USA
| | - R Graham Barr
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Medical Center, New York, NY, 10032, USA
| | - Mark T Dransfield
- Division of Pulmonary, Allergy and Critical Care Medicine and Lung Health Center, University of Alabama at Birmingham, THT 422, 1720, 2nd Avenue South, Birmingham, AL, 35294, USA
- UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
- Birmingham Veterans Affairs Hospital, Birmingham, AL, 35294, USA
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Kunadian V, Chan D, Ali H, Wilkinson N, Howe N, McColl E, Thornton J, von Wilamowitz-Moellendorff A, Holstein EM, Burns G, Fisher A, Stocken D, De Soyza A. Antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: protocol of a randomised controlled proof-of-concept trial (APPLE COPD-ICON 2). BMJ Open 2018; 8:e020713. [PMID: 29804061 PMCID: PMC5988059 DOI: 10.1136/bmjopen-2017-020713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION The antiplatelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease (APPLE COPD-ICON2) trial is a prospective 2×2 factorial, double-blinded proof-of-concept randomised controlled trial targeting patients with chronic obstructive pulmonary disease (COPD) at high risk of cardiovascular disease. The primary goal of this trial is to investigate if treatment with antiplatelet therapy will produce the required response in platelet function measured using the Multiplate test in patients with COPD. METHODS AND ANALYSIS Patients with COPD are screened for eligibility using inclusion and exclusion criteria. Eligible patients are randomised and allocated into one of four groups to receive aspirin plus placebo, ticagrelor plus placebo, aspirin plus ticagrelor or placebo only. Markers of systemic inflammation, platelet reactivity, arterial stiffness, carotid intima-media thickness (CIMT), lung function and quality of life questionnaires are assessed. The primary outcome consists of inhibition (binary response) of aspirin and ADP-induced platelet function at 6 months. Secondary outcomes include changes in inflammatory markers, CIMT, non-invasive measures of vascular stiffness, quality of life using questionnaires (EuroQol-five dimensions-five levels of perceived problems (EQ5D-5L), St. George's COPD questionnaire) and to record occurrence of repeat hospitalisation, angina, myocardial infarction or death from baseline to 6 months. Safety outcomes will be rates of major and minor bleeding, forced expiratory volume in 1 s, forced vital capacity and Medical Research Council dyspnoea scale. ETHICS AND DISSEMINATION The study was approved by the North East-Tyne and Wear South Research Ethics Committee (15/NE/0155). Findings of the study will be presented in scientific sessions and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN43245574; Pre-results.
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Affiliation(s)
- Vijay Kunadian
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
- Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Danny Chan
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
- Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Hani Ali
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
- Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nina Wilkinson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Nicola Howe
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine McColl
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jared Thornton
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | | | - Eva-Maria Holstein
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Graham Burns
- Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Andrew Fisher
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
- Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Deborah Stocken
- Leeds Institute of Clinical Trial Research, University of Leeds, Leeds, UK
| | - Anthony De Soyza
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
- Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
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Liang Y, Wang M, Xu X, Li N, Zhou Q, He B. Reduced Forced Expiratory Volume in 1 Second Percentage Predicted Is Associated With Diffuse Coronary Atherosclerosis in Hospitalized Patients Undergoing Coronary Angiography. Am J Med Sci 2018; 355:307-313. [PMID: 29661343 DOI: 10.1016/j.amjms.2017.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 12/19/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Reduced forced expiratory volume in 1 second percentage (FEV1%) predicted is closely related to cardiovascular mortality. However, evidence regarding the correlation between FEV1% predicted and the severity of coronary atherosclerosis observed on coronary angiography is still limited. We aimed to explore whether a decline in FEV1% predicted was associated with diffuse coronary atherosclerosis in hospitalized patients. METHODS A cross-sectional study enrolling hospitalized patients with cardiovascular symptoms undergoing both coronary angiography and lung function testing was conducted. The correlation between FEV1% predicted and angiographic characteristics, including the number of diseased vessels, total number of coronary lesions and Gensini score was analyzed. RESULTS Eighty-five patients were included. Patients with ≥2-vessel disease had significantly lower FEV1% predicted than patients with <2-vessel disease (60.9% ± 19.7% versus 77.2% ± 19.7%, P < 0.001). FEV1% predicted was inversely related to the total number of coronary lesions (β = -0.029, P = 0.002) and Gensini score (β = -0.525, P = 0.006). FEV1% predicted was independently associated with ≥2-vessel disease (odds ratio = 0.961, P = 0.007), total number of coronary lesions (adjusted β = -0.039, P < 0.001) and Gensini score (adjusted β = -0.602, P = 0.005) after adjustment for other traditional cardiovascular risk factors. In the coronary artery disease subgroup, FEV1% predicted maintained an independent and negative relationship with ≥2-vessel disease, total number of coronary lesions and Gensini score. CONCLUSIONS Reduced FEV1% predicted was closely associated with multivessel coronary disease and diffuse coronary atherosclerosis in hospitalized patients undergoing coronary angiography.
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Affiliation(s)
- Ying Liang
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, China
| | - Meng Wang
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, China
| | - Xinye Xu
- Department of Cardiology, Peking University Third Hospital, Beijing, China
| | - Nan Li
- Department of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Qingtao Zhou
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, China
| | - Bei He
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, China.
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10
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Gelinas JC, Lewis NC, Harper MI, Melzer B, Agar G, Rolf JD, Eves ND. Aerobic exercise training does not alter vascular structure and function in chronic obstructive pulmonary disease. Exp Physiol 2017; 102:1548-1560. [PMID: 28857336 DOI: 10.1113/ep086379] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 08/29/2017] [Indexed: 01/17/2023]
Abstract
NEW FINDINGS What is the central question of this study? Chronic obstructive pulmonary disease (COPD) is associated with endothelial dysfunction, arterial stiffness and systemic inflammation, which are linked to increased cardiovascular disease risk. We asked whether periodized aerobic exercise training could improve vascular structure and function in patients with COPD. What is the main finding and its importance? Eight weeks of periodized aerobic training did not improve endothelial function, arterial stiffness or systemic inflammation in COPD, despite improvements in aerobic capacity, blood pressure and dyspnoea. Short-term training programmes may not be long enough to improve vascular-related cardiovascular risk in COPD. Chronic obstructive pulmonary disease (COPD) has been associated with endothelial dysfunction and arterial stiffening, which are predictive of future cardiovascular events. Although aerobic exercise improves vascular function in healthy individuals and those with chronic disease, it is unknown whether aerobic exercise can positively modify the vasculature in COPD. We examined the effects of 8 weeks of periodized aerobic training on vascular structure and function and inflammation in 24 patients with COPD (age, 69 ± 7 years; forced expiratory volume in 1 second as a percentage of predicted (FEV1 %pred), 68 ± 19%) and 20 matched control subjects (age, 64 ± 5 years; FEV1 %pred, 113 ± 16%) for comparison. Endothelial function was measured using brachial artery flow-mediated dilatation, whereas central and peripheral pulse wave velocity, carotid artery intima-media thickness, carotid compliance, distensibility and β-stiffness index were measured using applanation tonometry and ultrasound. Peak aerobic power (V̇O2 peak ) was measured using an incremental cycling test. Upper and lower body cycling training was performed three times per week for 8 weeks, and designed to optimize vascular adaptation by increasing and sustaining vascular shear stress. Flow-mediated dilatation was not increased in COPD patients (+0.15 ± 2.27%, P = 0.82) or control subjects (+0.34 ± 3.20%, P = 0.64) and was not different between groups (P = 0.68). No significant improvements in central pulse wave velocity (COPD, +0.30 ± 1.79 m s-1 versus control subjects, -0.34 ± 1.47 m s-1 ) or other markers of vascular structure or function were found within or between groups. The V̇O2 peak increased significantly in COPD and control subjects, and was greater in control subjects (1.6 ± 1.4 versus 4.1 ± 3.7 ml kg min-1 , P = 0.003), while blood pressure and dyspnoea were reduced in COPD patients (P < 0.05). These findings demonstrate that 8 weeks of aerobic training improved cardiorespiratory fitness and blood pressure in COPD but had little effect on other established markers of cardiovascular disease risk.
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Affiliation(s)
- Jinelle C Gelinas
- Centre for Heart, Lung and Vascular Health, University of British Columbia, Kelowna, BC, Canada
| | - Nia C Lewis
- Centre for Heart, Lung and Vascular Health, University of British Columbia, Kelowna, BC, Canada
| | - Megan I Harper
- Centre for Heart, Lung and Vascular Health, University of British Columbia, Kelowna, BC, Canada
| | | | | | | | - Neil D Eves
- Centre for Heart, Lung and Vascular Health, University of British Columbia, Kelowna, BC, Canada
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11
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Ambrosino P, Lupoli R, Cafaro G, Iervolino S, Carone M, Pappone N, Di Minno MND. Subclinical carotid atherosclerosis in patients with chronic obstructive pulmonary disease: a meta-analysis of literature studies. Ann Med 2017; 49:513-524. [PMID: 28326854 DOI: 10.1080/07853890.2017.1311022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) patients have an increased cardiovascular (CV) morbidity and mortality. Common carotid intima-media thickness (CCA-IMT) and carotid plaques are surrogate markers of subclinical atherosclerosis and predictors of CV events. METHODS AND RESULTS We performed a meta-analysis to evaluate the association between COPD and subclinical atherosclerosis. Studies evaluating the impact of COPD on CCA-IMT and on the prevalence of carotid plaques were systematically searched. RESULTS Twenty studies (2082 COPD patients and 4844 controls) were included, 12 studies with data on CCA-IMT (13 data-sets on 1180 COPD patients and 2312 controls) and 12 studies reporting on the prevalence of carotid plaques (1231 COPD patients and 4222 controls). Compared to controls, COPD patients showed a significantly higher CCA-IMT (mean difference [MD]: 0.201 mm; 95%CI: 0.142, 0.260; p < .001), and an increased prevalence of carotid plaques (Odds Ratio [OR]: 2.503; 95%CI: 1.333, 2.175; p < .0001). Meta-regression models showed a direct association between disease severity [as expressed by Global Initiative for Chronic Obstructive Lung Disease (GOLD) class] and the difference in the risk of carotid plaques presence between COPD patients and controls. CONCLUSIONS COPD is significantly associated with subclinical atherosclerosis. These findings may be useful to plan adequate CV prevention strategies. Key messages COPD patients show a higher CCA-IMT and an increased prevalence of carotid plaques compared with controls. A more severe pulmonary disease is associated with a higher prevalence of carotid plaques in COPD patients. Screening for subclinical atherosclerosis may be worthy in COPD patients to plan specific prevention strategies.
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Affiliation(s)
- Pasquale Ambrosino
- a Department of Clinical Medicine and Surgery , Federico II University , Naples , Italy.,b ICS Maugeri SpA SB, Scientific Institute of Telese Terme - IRCCS , Telese Terme (BN) , Italy
| | - Roberta Lupoli
- a Department of Clinical Medicine and Surgery , Federico II University , Naples , Italy
| | - Giovanni Cafaro
- a Department of Clinical Medicine and Surgery , Federico II University , Naples , Italy
| | - Salvatore Iervolino
- b ICS Maugeri SpA SB, Scientific Institute of Telese Terme - IRCCS , Telese Terme (BN) , Italy
| | - Mauro Carone
- c ICS Maugeri SpA SB, Scientific Institute of Cassano delle Murge - IRCCS , Cassano delle Murge (BA) , Italy
| | - Nicola Pappone
- b ICS Maugeri SpA SB, Scientific Institute of Telese Terme - IRCCS , Telese Terme (BN) , Italy
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Kudo K, Hata J, Matsumoto K, Shundo Y, Fukuyama S, Inoue H, Kitazono T, Kiyohara Y, Ninomiya T, Nakanishi Y. Association of Airflow Limitation With Carotid Atherosclerosis in a Japanese Community - The Hisayama Study. Circ J 2017; 81:1846-1853. [PMID: 28592724 DOI: 10.1253/circj.cj-16-1305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There has been no large-scale observational study examining the association between chronic obstructive pulmonary disease (COPD) or airflow limitation and carotid atherosclerosis in the general population across a wide range of generations in Asia. In the present study we assessed the association between airflow limitation and carotid intima-media thickness (IMT) in a general Japanese population, with consideration of a comprehensive array of cardiovascular risk factors.Methods and Results:In all, 2,099 community-dwelling Japanese subjects were included in the study. Airflow limitation was defined by spirometry. Maximum and mean IMT values were measured using carotid ultrasonography. Among the subjects, 352 (16.8%) had airflow limitation. The geometric mean values of maximum IMT and mean IMT were significantly higher in subjects with than without airflow limitation (1.27 vs. 1.18 mm, respectively, for maximum IMT; 0.73 mm vs. 0.72 mm, respectively, for mean IMT) and increased with the severity of airflow limitation after adjustment for conventional risk factors, including smoking habits and serum high-sensitivity C-reactive protein. It should be noted that the magnitude of these associations was greater in the middle-aged (40-64 years) than elderly (≥65 years) subgroup. CONCLUSIONS The findings of the present study suggest that airflow limitation is a significant risk factor for carotid atherosclerosis, especially in midlife, in the general Japanese population.
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Affiliation(s)
- Kunihiro Kudo
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Koichiro Matsumoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University
| | - Yuki Shundo
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Satoru Fukuyama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University
| | - Hiromasa Inoue
- Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | | | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University
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13
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Ye C, Younus A, Malik R, Roberson L, Shaharyar S, Veledar E, Ahmad R, Ali SS, Latif MA, Maziak W, Feiz H, Aneni E, Nasir K. Subclinical cardiovascular disease in patients with chronic obstructive pulmonary disease: a systematic review. QJM 2017; 110:341-349. [PMID: 27539486 DOI: 10.1093/qjmed/hcw135] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) accounts for a significant portion of deaths in patients with COPD; however, evidence for early detection strategies for CVD in this population remain limited. Our paper aims to summarize existing data regarding subclinical CVD in patients with COPD with a view to identifying screening strategies in these patients. METHODS A systematic review of published literature was conducted for studies examining the relationship of COPD and markers of subclinical disease such as coronary artery calcification (CAC), carotid intima media thickness (cIMT), endothelial dysfunction, arterial stiffness as measured by pulse wave velocity (PWV) and augmentation indices (AIx). Both MEDLINE and EMBASE databases were searched till October 2015. RESULTS A total of 22 studies were included in the review. Compared with control subjects, patients with COPD had significantly higher cIMT (SMD 0.53, 95% CI 0.16-0.90), PWV (SMD 0.91, 95% CI 0.67-1.16) and AIx (SMD 0.86, 95% CI 0.52-1.19). Additionally, an overall higher prevalence of subclinical CVD as assessed by CAC, ABI and FMD was noted in our review. CONCLUSION Although our findings need further evaluation in prospective studies, our review presents significant evidence in support of increased subclinical CVD burden in COPD patients independent of smoking status. Further large-scale case-control studies are required to highlight the significance of subclinical CVD screening in COPD patients.
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Affiliation(s)
- C Ye
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
- Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153, USA
| | - A Younus
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
| | - R Malik
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
| | - L Roberson
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
| | - S Shaharyar
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
- Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, USA
| | - E Veledar
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
| | - R Ahmad
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
| | - S S Ali
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
- University of Manchester School of Medicine, Stopford Building, Oxford Road, Manchester M13 9PT, UK
| | - M A Latif
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
| | - W Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL 33174, USA
| | - H Feiz
- Aventura Hospital and Medical Center, 20900 Biscayne Blvd, Aventura, FL 33180, USA
| | - E Aneni
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL 33174, USA
- Department of Internal Medicine, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA
| | - K Nasir
- From the Baptist Health South Florida, Center for Healthcare Advancement and Outcomes, 1691 Michigan Avenue Suite 500; Miami Beach, FL 33139, USA
- University of Manchester School of Medicine, Stopford Building, Oxford Road, Manchester M13 9PT, UK
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL 33174, USA
- Herbert Wertheim College of Medicine, Florida International University, 11200 Southwest 8th Street, Miami, FL 33199, USA
- Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Johns Hopkins University, 1800 Orleans St, Baltimore, MD 21287, USA
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Cherepii N, Rasputina L. DIAGNOSTICS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN REAL CLINICAL PRACTICE: HYPODIAGNISTICS OR HYPERDIAGNOSTICS. EUREKA: Health Sciences 2017; 3:65-72. [DOI: 10.21303/2504-5679.2017.00340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
According to the data of the world statistics there is observed the continuous growth of chronic obstructive pulmonary disease (COPD). According to the last data of the World health organization (WHO), for today there is near 250 mln persons with chronic obstructive pulmonary disease (COPD), and this disease becomes as cause of death of near 3 mln persons annually.
Aim: to establish the prevalence of undiagnosed chronic pulmonary disease (COPD) among persons, who consider themselves as healthy ones and regularly undergo medical check-ups; to estimate the frequency of chronic obstructive pulmonary disease (COPD) according to the data of medical documentation.
Methods and materials: 525 persons, older than 35, who did not have in an anamnesis any chronic diseases of respiratory tract, were interrogated. At the following stage, persons, who had taken 18 points or more underwent a spirography with bronchodilatation test, using 400 mcg of salbutamol and were interrogated by the modified questionnaire of short breath by the medical research council (MRC) and test of the chronic obstructive pulmonary disease estimation (COPD) (TEC). There were examined 136 patients, mean age (51,5±0,8), men were 81(59,5 %) mean age (52,2±1,1) and women – 55(40,4 %) mean age (50,7±0,9).
There were analyzed 56 medical stories of patients, treated at therapeutic departments of the city clinic because of internal organs diseases with the concomitant diagnosis of chronic obstructive pulmonary disease (COPD).
Among persons with first revealed chronic obstructive pulmonary disease у 21 (26,6 %) was reveled І severity degree according to GOLD, in 26 persons (32,9 %) – GOLD ІІ, in 28 (35,4 %) – GOLD ІІІ, in 4 (5,1 %) – GOLD ІV severity degree, so 32 patients did not receive basic treatment at all.
At the same time among patients with COPD diagnosis in medical documentation only in 38,4 % this diagnosis was spirographically verified, the hyperdiagnostics of disease on the base of complaints and age characteristic took place in other cases.
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15
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El-Shabrawy M, Eldamanhory AS. Study of cardiovascular diseases in hospitalized AECOPD patients. Egyptian Journal of Chest Diseases and Tuberculosis 2017. [DOI: 10.1016/j.ejcdt.2016.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Wang LY, Zhu YN, Cui JJ, Yin KQ, Liu SX, Gao YH. Subclinical atherosclerosis risk markers in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. Respir Med 2016; 123:18-27. [PMID: 28137492 DOI: 10.1016/j.rmed.2016.12.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 12/05/2016] [Accepted: 12/07/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular morbidity and mortality. Identifying early changes of cardiovascular system before the occurrence of fatal clinical event is critical for the management of COPD. We performed a meta-analysis to investigate the associations between COPD and subclinical markers of cardiovascular risk. METHODS We searched PUBMED, EMBASE for studies published before Aug 1st, 2016, on the association between COPD and carotid intima-media thickness (CIMT), prevalence of carotid plaques, flow-mediated dilation (FMD), pulse-wave velocity (PWV) and augmentation index (AIx). RESULTS Thirty-two studies (3198 patients, 13867 controls) were included. Compared with controls, COPD patients had significantly higher CIMT (MD: 0.10 mm; 95% CI: 0.04, 0.16; p = 0.0007), PWV (SMD: 0.70; 95% CI: 0.52, 0.88; p < 0.0001), AIx (MD: 4.60%; 95% CI: 0.52, 8.68; p = 0.03), AIx@75 (AIx normalized to a heart rate of 75 beats per minute) (MD: 4.59%; 95% CI: 2.80, 6.38; p < 0.0001), prevalence of carotid plaque (OR: 2.54; 95% CI: 2.04, 3.15; p < 0.0001), and significantly lower FMD (MD: -4.21%; 95% CI: -6.71, -1.71; p = 0.001). Sensitivity and subgroups analyses substantially confirmed our results. Meta-regression analysis revealed that spirometry (as expressed by FEV1%predicted) might influence on PWV. CONCLUSIONS These findings indicate that COPD, even in mild to moderate patients, had greater impaired markers of subclinical atherosclerosis and cardiovascular risk. However, further studies are still needed to address confounders, such as age, smoking, hypertension, diabetes etc, which might affect the associations in COPD patients.
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Affiliation(s)
- Ling-Yun Wang
- Department of Ultrasound Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ya-Nan Zhu
- Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Juan-Juan Cui
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ke-Qin Yin
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shao-Xia Liu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Yong-Hua Gao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
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Lee JH, Kang YS, Jeong YJ, Yoon YS, Kwack WG, Oh JY. Relationship between FEV1 and Cardiovascular Risk Factors in General Population without Airflow Limitation. Can Respir J 2016; 2016:8319849. [PMID: 28018129 DOI: 10.1155/2016/8319849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/06/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. We aimed to determine the value of lung function measurement for predicting cardiovascular (CV) disease by evaluating the association between FEV1 (%) and CV risk factors in general population. Materials and Methods. This was a cross-sectional, retrospective study of subjects above 18 years of age who underwent health examinations. The relationship between FEV1 (%) and presence of carotid plaque and thickened carotid IMT (≥0.8 mm) was analyzed by multiple logistic regression, and the relationship between FEV1 (%) and PWV (%), and serum uric acid was analyzed by multiple linear regression. Various factors were adjusted by using Model 1 and Model 2. Results. 1,003 subjects were enrolled in this study and 96.7% (n = 970) of the subjects were men. In both models, the odds ratio of the presence of carotid plaque and thickened carotid IMT had no consistent trend and statistical significance. In the analysis of the PWV (%) and uric acid, there was no significant relationship with FEV1 (%) in both models. Conclusion. FEV1 had no significant relationship with CV risk factors. The result suggests that FEV1 may have no association with CV risk factors or may be insensitive to detecting the association in general population without airflow limitation.
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Cheng J, Pike D, Chow TWS, Kirby M, Parraga G, Chiu B. Three-dimensional ultrasound measurements of carotid vessel wall and plaque thickness and their relationship with pulmonary abnormalities in ex-smokers without airflow limitation. Int J Cardiovasc Imaging 2016; 32:1391-1402. [DOI: 10.1007/s10554-016-0931-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/21/2016] [Indexed: 11/29/2022]
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Pan J, Xu L, Cai SX, Jiang CQ, Cheng KK, Zhao HJ, Zhang WS, Jin YL, Lin JM, Thomas GN, Lam TH. The association of pulmonary function with carotid atherosclerosis in older Chinese: Guangzhou Biobank Cohort Study-CVD Subcohort. Atherosclerosis 2015; 243:469-76. [DOI: 10.1016/j.atherosclerosis.2015.09.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 09/28/2015] [Accepted: 09/29/2015] [Indexed: 11/19/2022]
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Lindenmaier TJ, Kirby M, Paulin G, Mielniczuk L, Cunningham IA, Mura M, Licskai C, Parraga G. Pulmonary Artery Abnormalities in Ex-smokers with and without Airflow Obstruction. COPD 2015; 13:224-34. [DOI: 10.3109/15412555.2015.1074666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sadek SH, Hassan AA, AbdElrahman G, Kasem SM, AbdElwahed L, Eldein HS, Zedan M. Subclinical cardiovascular changes in chronic obstructive pulmonary disease patients: Doppler ultrasound evaluation. Egypt J Bronchol 2015. [DOI: 10.4103/1687-8426.158046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pike D, Kirby M, Lindenmaier TJ, Sheikh K, Neron CE, Hackam DG, Spence JD, Fenster A, Paterson NAM, Sin DD, Coxson HO, McCormack DG, Parraga G. Pulmonary Abnormalities and Carotid Atherosclerosis in Ex-Smokers without Airflow Limitation. COPD 2014; 12:62-70. [DOI: 10.3109/15412555.2014.908833] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pike D, Lindenmaier TJ, Sin DD, Parraga G. Imaging evidence of the relationship between atherosclerosis and chronic obstructive pulmonary disease. ACTA ACUST UNITED AC 2014. [DOI: 10.2217/iim.13.70] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Chronic obstructive pulmonary disease (COPD) is an inflammatory disease of the lung associated with progressive airflow limitation and punctuated by episodes of acute exacerbation. There is growing recognition that the inflammatory state associated with COPD is not confined to the lungs but also involves the systemic circulation and can impact nonpulmonary organs. Epidemiologic and mechanistic studies indicate that COPD is associated with a high frequency of coronary artery disease, congestive heart failure and cardiac arrhythmias, independent of shared risk factors. Possible pathways include complex interrelationships between chronic low-grade systemic inflammation and oxidative stress as well as shared risk factors such as age, cigarette smoking, and environmental pollutants. In this review, we provide an overview of the epidemiologic data linking COPD with cardiovascular disease, comment on the interrelationships among COPD, inflammation, and cardiovascular disease, and highlight diagnostic and therapeutic challenges.
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Affiliation(s)
- Surya P Bhatt
- UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, Ala
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