Key result
Carotid intima-media thickness significantly increased with COPD severity, measuring 1.0±0.2 mm in mild, 1.5±0.2 mm in moderate, and 1.75±0.05 mm in severe disease (P<0.001).
Why the study?
COPD-associated systemic inflammation contributes to atherosclerosis, but the relationship between carotid intima-media thickness and post-bronchodilator FEV1 in COPD required evaluation.
Does COPD severity (measured by post-FEV1) correlate with carotid intima-media thickness (IMT) and inflammatory markers in smokers?
Cross-Sectional (n=50)
No
Does COPD severity (measured by post-FEV1) correlate with carotid intima-media thickness (IMT) and inflammatory markers in smokers?
p-value: p=<0.001
Increased severity of COPD is significantly associated with increased carotid intima-media thickness, CRP, and lipid levels, suggesting a higher burden of subclinical atherosclerosis.
Associated with greater subclinical atherosclerosis in severe COPD; leaves open prospective validation before clinical adoption.
Context Chronic obstructive pulmonary disease (COPD) is associated with significant systemic inflammatory response, with downstream adverse clinical effects. This inflammatory response is referred to oxidative stress and inflammatory mediators, which play an important role in the development of atherosclerosis. Preclinical carotid atherosclerosis, characterized by increased intima-media thickness (IMT) on ultrasound imaging, is a surrogate marker for atherosclerosis burden and risk of cardiovascular diseases. Aim To evaluate carotid IMT, in relation to post-forced expiratory volume in 1 s (FEV1) (FEV1 after bronchodilator inhalation) in COPD. Patients and methods A total of 50 patients with COPD were clinically and functionally diagnosed. IMT was measured by B-mode ultrasonography. The correlations between IMT, C-reactive protein (CRP), serum lipids, and post-FEV1 were analyzed. The primary outcome was carotid arteries’ IMT in relation to post-FEV1. Results Cases were divided into three groups according to post-FEV1. In mild COPD severity, mean±SD IMT value was 1.0±0.2, whereas in moderate severity, it was 1.5±0.2, and in severe COPD, IMT was 1.75±0.05 ( P <0.001). In mild group, mean±SD value of CRP was 5.2±1.7, in moderate group was 7.5±1.5, and in severe COPD group was 8.4±0.2 ( P <0.001). When CRP was correlated with IMT, the correlation was found to be highly significant ( P <0.001). In severe airway obstruction group, mean values of serum cholesterol and triglycerides were 239.5 and 189.5, respectively; in moderate group 219.4 and 161.9, respectively; and in mild group 184.2 and 125.6, respectively ( P <0.000). Multinomial logistic regression analysis revealed low post-FEV1 as predictor of IMT ( P <0.000). Conclusion Carotid duplex should be added to the standard investigations of COPD.
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Abdalrazik et al. (2018) conducted a cross-sectional in Chronic Obstructive Pulmonary Disease (COPD) (n=50). Carotid intima-media thickness significantly increased with COPD severity, measuring 1.0±0.2 mm in mild, 1.5±0.2 mm in moderate, and 1.75±0.05 mm in severe disease (P<0.001).
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