Abstract
Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a multisystem disorder with extra-pulmonary manifestations like cardiovascular and cerebrovascular co-morbidities which are associated with higher prevalence of carotid plaques. Mean Carotid Intima-Media Thickness (cIMT) and morphological plaque characterisation1 into Types 1, 2, 3 and 4 using carotid ultrasonography are validated methods that can predict future vascular events. Types 1 and 2 are unstable and vulnerable to rupture.
Aim: To determine the carotid plaque prevalence, mean cIMT and morphologic types among elderly Indian COPD patients and control subjects.
Methods: A total of 51 COPD and 54 Control subjects were evaluated. Diagnosis of COPD was confirmed on spirometry. All study subjects underwent Carotid doppler ultrasound. Plaque was defined as cIMT>1.2mm and at least 50% thicker than the neighbouring segments. Mean cIMT values were computed & plaque morphological characterisation was determied using standardized ultrasonography protocols.
Result:
1.)Among 51 COPD patients plaques were found in 26(51%) patients compared to 15(28%) in controls.(p=0.017)
2.)Average mean cIMT in COPD patients was 1.11mm and 0.83mm in Controls.(p=0.003).
3.)Type 1 & Type 2 plaques were found in 31.3% & 35% in COPD patients compared to 14.8% & 9.2% in Control Subjects respectively.
Conclusion: There is raised average mean cIMT and higher prevalence of unstable Type 1 and Type 2 plaques found in COPD patients. These predisposes them to higher risk of future cerebrovascular events.
References: 1. Edward I., et al. The Extracranial Cerebral vessels. Diagnostic Ultrasound 4th edition. Elsevier Mosby Inc. USA. 2011; 25; 950-965.
- Copyright ©the authors 2016