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Associations between COPD related manifestations: a cross-sectional study

Lookup NU author(s): Dr George Petrides



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: Cardiovascular disease, osteoporosis and emphysema are associated with COPD. Associations between these factors and whether they predict all-cause mortality in COPD patients are not well understood. Therefore, we examined 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), emphysema (PI-950 and 15th percentile) and all-cause mortality in a COPD cohort.Methods: We assessed CAC, TAC, bone attenuation of the thoracic vertebrae, PI-950 and 15th percentile on low-dose chest computed tomography in COPD subjects. We measured arterial stiffness as carotid-radial pulse wave velocity (PWV), and identified deaths from the 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-specificed 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, p = 0.04) and lower bone attenuation (OR 0.32, p = 0.02), 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).Conclusions: Increased CAC was associated with increased arterial stiffness and lower bone density in a COPD cohort. In addition, CAC, TAC and extent of emphysema predicted all-cause mortality.

Publication metadata

Author(s): Romme EAPM, McAllister DA, Murchison JT, Van Beek EJR, Petrides GS, Price COS, Rutten EPA, Smeenk FWJM, Wouters EFM, MacNee W

Publication type: Article

Publication status: Published

Journal: Respiratory Research

Year: 2013

Volume: 14

Online publication date: 19/11/2013

Acceptance date: 22/10/2013

Date deposited: 08/01/2016

ISSN (print): 1465-993X

ISSN (electronic): 1465-9921

Publisher: BioMed Central Ltd


DOI: 10.1186/1465-9921-14-129


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