RT Journal Article
SR Electronic
T1 Associations between arterial calcification and stiffness, bone density, emphysema and all-cause mortality in COPD patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P5105
VO 42
IS Suppl 57
A1 Elisabeth Romme
A1 David McAllister
A1 John Murchison
A1 Edwin Van Beek
A1 George Petrides
A1 Erica Rutten
A1 Frank Smeenk
A1 Emiel Wouters
A1 William MacNee
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P5105.abstract
AB 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.