Carotid intima‐media thickness in chronic obstructive pulmonary disease and survival: a multicenter prospective study

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is associated withincreased cardiovascular morbidity and mortality. Carotid intima-media thickness(CIMT) is a noninvasive method assessing atherosclerosis.Objective: It was aimed to determine relationship and survival between COPD andCIMT.Methods: CIMT was measured using Doppler ultrasound (USG) in 668 stable COPDpatients at 24 centers. Patients were followed-up for 2 years.Results: There were 610 patients who completed the study. There were 200 patientsCIMT with <0.78 mm (group 1), and 410 with CIMT ? 0.78 mm (group 2). Therewas a significant difference at the parameters of age, gender, smoking load, biomassexposure, GOLD groups and degree of airway obstruction (FEV1) between groups1 and 2. Our results revealed positive correlations between mean CIMT and age,smoking load (pack-years), biomass exposure (years), exacerbation rate (last year),duration of hypertension (years) and cholesterol level; negative correlations betweenCIMT and FEV1 (P < 0.05). According to logistic regression model, compared withgroup A, risk of CIMT increase was 2.2-fold in group B, 9.7-fold in group C and4.4-fold in group D (P < 0.05). Risk of CIMT increase was also related with cholesterollevel (P < 0.05). Compared with infrequent exacerbation, it was 2.8-fold in thepatients with frequent exacerbation (P < 0.05). The mean survival time was slightlyhigher in group 1, but not significant (23.9 vs 21.8 months) (P > 0.05).Conclusion: This study is the first regarding CIMT with combined GOLD assessmentgroups. It has revealed important findings supporting the increase in atherosclerosisrisk in COPD patients. We recommend Doppler USG of the carotid artery inCOPD patients at severe stages.