Atherosclerosis is Associated Comorbidity in Patients with Chronic Obstructive Pulmonary Disease: Ultrasound Assessment of Carotid Intima Media ThicknessManal R. Hafez1, Eman Sobh1, Omaima I. Abo-elkheir2, Lobna K. Sakr3
1Department of Chest Diseases, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
2Department of Community and Occupational Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
3Department of Radiodiagnosis, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
Objective: To assess atherosclerotic comorbidity in chronic obstructive pulmonary disease (COPD) patients and its relationship to COPD severity, hypoxemia, and hypercapnia. Keywords: Arterial stiffness in COPD, atherosclerosis, cardiovascular risk in COPD, carotid intima media thickness, COPD
Methods: A hospital-based observational case-control study was conducted on 86 male COPD patients, and 86 age-matched healthy subjects (non-COPD group). Carotid intima-media thickness (CIMT) was assessed by Doppler ultrasound; in addition, spirometry and arterial blood gas tests were done.
Results: CIMT was significantly increased in the COPD group compared to the non-COPD group (0.84±0.15 vs. 0.63±0.076, p<0.001). When the CIMT value of ≥0.8 mm was defined as a cutoff value for a thickened CIMT complex, 64% of COPD patients versus 8.1% of non-COPD subjects had a thickened CIMT. COPD patients with a thickened CIMT were older and had a higher PaCO2, lower FEV1%, FVC, and FEF2575% compared to COPD patients with a normal CIMT. Thickened CIMT in COPD patients was significantly associated with hypoxemia (p=0.008, OR=8.2), hypercapnia (p=0.04, OR=6.2), and airflow limitation (p=0.11, OR=2.1). There was no significant difference in CIMT in relation to COPD severity (p=0.83).
Conclusion: Atherosclerosis is prevalent in COPD patients, even in the early stages of the disease. Hypoxemia, hypercapnia, and airflow limitation are risk factors of atherosclerosis in COPD patients.
Manal R. Hafez, Eman Sobh, Omaima I. Abo-elkheir, Lobna K. Sakr. Atherosclerosis is Associated Comorbidity in Patients with Chronic Obstructive Pulmonary Disease: Ultrasound Assessment of Carotid Intima Media Thickness. Eurasian J Pulmonol. 2016; 18(3): 165-171
Corresponding Author: Eman Sobh, Egypt