Author(s):
E. A.
Romme, D. A.
McAllister, J. T.
Murchison, E. J.
Van Beek, G. S.
Petrides, C. O.
Price, E. P.
Rutten, F. W.
Smeenk, E. F.
Wouters, W.
Macnee
Abstract:
BACKGROUND: Cardiovascular disease, osteoporosis and emphysema are associated with COPD. Associations between these factors and whether they predict all-cause mortality in COPD patients are not well understood. Therefore, we examined associations between markers of cardiovascular disease (coronary artery calcification [CAC], thoracic aortic calcification [TAC] and arterial stiffness), bone density (bone attenuation of the thoracic vertebrae), emphysema (PI-950 and 15th percentile) and all-cause mortality in a COPD cohort. METHODS: We assessed CAC, TAC, bone attenuation of the thoracic vertebrae, PI-950 and 15th percentile on low-dose chest computed tomography in COPD subjects. We measured arterial stiffness as carotid-radial pulse wave velocity (PWV), and identified deaths from the national register. RESULTS: We studied 119 COPD subjects; aged 67.8 +/-7.3, 66% were males and mean FEV1% predicted was 46.0 +/-17.5. Subjects were classified into three pre-specificed groups: CAC = 0 (n = 14), 0 < CAC <= 400 (n = 41) and CAC > 400 (n = 64). Subjects with higher CAC were more likely to be older (p < 0.001) and male (p = 0.03), and more likely to have higher systolic blood pressure (p = 0.001) and a history of hypertension (p = 0.002) or ischemic heart disease (p = 0.003). Higher CAC was associated with higher PWV (OR 1.62, p = 0.04) and lower bone attenuation (OR 0.32, p = 0.02), but not with 15th percentile, after adjustment for age, sex and pack-years of smoking. In a Cox proportional hazards model, CAC, TAC and 15th percentile predicted all-cause mortality (HR 2.01, 2.09 and 0.66, respectively). CONCLUSIONS: Increased CAC was associated with increased arterial stiffness and lower bone density in a COPD cohort. In addition, CAC, TAC and extent of emphysema predicted all-cause mortality.Trial registration: Lothian NHS Board, Lothian Research Ethics Committee, LREC/2003/8/28.
Full version:
Available here
Click the link to go to an external website with the full version of the paper
ISBN:
1465-993X (Electronic)1465-9921 (Linking)
Publication Year:
2013
Periodical:
Respir Res
Periodical Number:
1
Volume:
14
Pages:
129
Author Address: