Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands.
Respir Res. 2013 Nov 19;14(1):129. doi: 10.1186/1465-9921-14-129.
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.
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.
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).
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.
Lothian NHS Board, Lothian Research Ethics Committee, LREC/2003/8/28.
心血管疾病、骨质疏松症和肺气肿与 COPD 相关。这些因素之间的关联以及它们是否能预测 COPD 患者的全因死亡率尚不清楚。因此，我们在 COPD 患者队列中检查了心血管疾病标志物（冠状动脉钙化[CAC]、胸主动脉钙化[TAC]和动脉僵硬度）、骨密度（胸椎体骨衰减）、肺气肿（PI-950 和 15%分位数）与全因死亡率之间的关系。
我们评估了 COPD 患者低剂量胸部 CT 上的 CAC、TAC、胸椎体骨衰减、PI-950 和 15%分位数，并从国家登记处确定了死亡情况。
我们研究了 119 名 COPD 患者；年龄 67.8±7.3 岁，66%为男性，预计 FEV1%为 46.0±17.5。患者被分为三个特定组：CAC=0（n=14）、0<CAC≤400（n=41）和 CAC>400（n=64）。CAC 较高的患者更有可能年龄较大（p<0.001）和男性（p=0.03），并且更有可能有较高的收缩压（p=0.001）和高血压病史（p=0.002）或缺血性心脏病（p=0.003）。经过年龄、性别和吸烟包年数的调整后，CAC 与较高的 PWV（OR 1.62，p=0.04）和较低的骨衰减（OR 0.32，p=0.02）相关，但与 15%分位数无关。在 Cox 比例风险模型中，CAC、TAC 和 15%分位数预测了全因死亡率（HR 分别为 2.01、2.09 和 0.66）。
在 COPD 队列中，CAC 增加与动脉僵硬度增加和骨密度降低有关。此外，CAC、TAC 和肺气肿程度预测了全因死亡率。
洛锡安国民保健署，洛锡安研究伦理委员会，LREC/2003/8/28。
