Key result
Patients with COPD had significantly higher markers of subclinical cardiovascular disease compared with controls, including cIMT (SMD 0.53; 95% CI 0.16-0.90) and PWV (SMD 0.91; 95% CI 0.67-1.16).
Why the study?
Is chronic obstructive pulmonary disease associated with increased markers of subclinical cardiovascular disease compared to control subjects?
Systematic Review
Is chronic obstructive pulmonary disease associated with increased markers of subclinical cardiovascular disease compared to control subjects?
Standardized Mean Difference: 0.53 (95% CI 0.16–0.9)
COPD is associated with a significantly increased burden of subclinical cardiovascular disease, highlighting the potential need for early screening strategies in this population.
Suggests targeted CVD evaluation in COPD; confirms association but leaves practice change open pending trials.
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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Ye et al. (2016) conducted a systematic review in Chronic obstructive pulmonary disease (COPD). Chronic obstructive pulmonary disease (COPD) vs. Control subjects was evaluated on Carotid intima media thickness (cIMT) (SMD 0.53, 95% CI 0.16-0.90). Patients with COPD had significantly higher markers of subclinical cardiovascular disease compared with controls, including cIMT (SMD 0.53; 95% CI 0.16-0.90) and PWV (SMD 0.91; 95% CI 0.67-1.16).
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