Chindhi Sandip, Thakur Surinder, Sarkar Malay, Negi Prakash C
Department of General Medicine, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
Department of Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
Lung India. 2015 Mar-Apr;32(2):137-41. doi: 10.4103/0970-2113.152624.
Chronic obstructive pulmonary disease (COPD) is an important non-communicable disease worldwide with a rising global incidence. COPD is associated with multiple co-morbidities. Patients with COPD are at increased risk of atherosclerosis and other cardiovascular events. Cardiovascular diseases are an important cause of morbidity and mortality in COPD. The present case-control study was designed to assess the relationship between sub-clinical atherosclerotic vascular diseases with COPD.
It was a prospective case-control blinded observational study. There were 142 COPD patients and 124 age-and sex-matched controls without COPD and cardiovascular diseases. Frequency of sub-clinical atherosclerosis was assessed by the carotid B-mode duplex ultrasonography assessment of carotid wall intima medial thickness (IMT). Plaque was defined as IMT of more than 1.2 mm.
Prevalence of carotid plaqing was significantly higher amongst patients of COPD (38.7%) compared to controls (13.7%, odds ratio 3.9, P < 0.0001). Multinomial logistic regression analysis revealed COPD as an independent predictor of carotid plaqing (r = 0.85, P < 0.023).
The frequency of carotid plaqing is high in COPD patients. Carotid plaqing may be due to shared risk factors or the presence of low-grade systemic inflammation. Presence of increased CIMT and carotid plaqing in COPD patients identifies early atherosclerotic changes and future cardiovascular risk. Hence screening of CIMT should be a part of cardiovascular assessment in patients with COPD.
慢性阻塞性肺疾病（COPD）是一种在全球范围内重要的非传染性疾病，其全球发病率呈上升趋势。COPD与多种合并症相关。COPD患者发生动脉粥样硬化和其他心血管事件的风险增加。心血管疾病是COPD发病和死亡的重要原因。本病例对照研究旨在评估亚临床动脉粥样硬化性血管疾病与COPD之间的关系。
这是一项前瞻性病例对照双盲观察性研究。有142例COPD患者和124例年龄及性别匹配的无COPD和心血管疾病的对照者。通过颈动脉B型双功超声评估颈动脉壁内膜中层厚度（IMT）来评估亚临床动脉粥样硬化的频率。斑块定义为IMT大于1.2毫米。
与对照组（13.7%）相比，COPD患者颈动脉斑块形成的患病率显著更高（38.7%，优势比3.9，P<0.0001）。多项逻辑回归分析显示COPD是颈动脉斑块形成的独立预测因素（r = 0.85，P<0.023）。
COPD患者颈动脉斑块形成的频率较高。颈动脉斑块形成可能是由于共同的危险因素或存在低度全身炎症。COPD患者中CIMT增加和颈动脉斑块形成提示早期动脉粥样硬化改变和未来心血管风险。因此，对CIMT的筛查应成为COPD患者心血管评估的一部分。
