Abstract
Background: Cardiovascular disease, osteoporosis and emphysema are associated with COPD. However, associations between these factors in COPD patients are not well understood.
Objective: To examine 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 [BATV]), emphysema (PI-950 and 15th percentile) and all-cause mortality in a COPD cohort.
Methods: We measured arterial stiffness as carotid-radial pulse wave velocity (PWV) in a COPD cohort. We assessed CAC, TAC, BATV, PI-950 and 15th percentile on chest CT and identified deaths from a 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-specified 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) and lower BATV (OR 0.32), 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).
Conclusion: Increased CAC was associated with increased arterial stiffness and lower bone density, and CAC, TAC and extent of emphysema predicted all-cause mortality in a COPD cohort.
- © 2013 ERS