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Domenech A, Muñoz-Montiel A, García-Casares N, Rioja J, Ruiz-Esteban P, Gutierrez-Castaño P, Prunera Pardell MJ, Olveira C, Valdivielso P, Sánchez-Chaparro MÁ. High risk of subclinical atherosclerosis in COPD exacerbator phenotype. Respir Med 2018; 141:165-171. [PMID: 30053963 DOI: 10.1016/j.rmed.2018.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 01/31/2023]
Abstract
It is not known whether COPD exacerbations contribute to an increased vascular risk already associated with the disease. For this reason, we prospectively evaluated 127 patients referred for a monographic COPD consultation. We classify as exacerbators those who had experienced two or more moderate exacerbations in the previous year, or who had had a hospital admission. All underwent a blood analysis, respiratory function tests, global cardiovascular and coronary risk estimates (with four of the most frequently used scores, and the Chronic Obstructive Pulmonary Disease Coronaropathy Risk (COPDCoRi) score, respectively); and an EcoDoppler to measure carotid intima-media thickness and the ankle-brachial index. Finally, we included 50 patients with exacerbator phenotypes and 57 with non-exacerbator phenotypes, ranging from 63 ± 7 years old, 74% of whom were male. The exacerbator phenotype increased the risk of carotid intima-media thickness above the 75th percentile range by a factor of almost three, independently of the severity of COPD and global cardiovascular risk. The association between the exacerbator phenotype and high c-IMT was more evident in patients under 65. In conclusion, the presence of subclinical atherosclerosis is independently associated with the exacerbator phenotype, with more pronounced differences in younger patient; which suggests that we should intensify control of vascular risk factors in these groups of patients.
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Affiliation(s)
- Adolfo Domenech
- Pulmonology Service, Regional University Hospital of Malaga, Malaga, Spain
| | - Ana Muñoz-Montiel
- Pulmonology Unit, Health Agency Costa del Sol, Marbella, Malaga, Spain
| | - Natalia García-Casares
- Dept of Medicine. Faculty of Medicine, University of Malaga. Medico-Sanitarias Research Centre (CIMES). University of Malaga. Institute for Research in Biomedicine IBIMA (Malaga), Spain
| | - José Rioja
- Laboratory of Lipids and Atherosclerosis, Medico-Sanitarias Research Center, University of Malaga, Malaga, Spain
| | - Pedro Ruiz-Esteban
- Nephrology Dept, Regional University Hospital of Malaga, Malaga University, The Biomedical Research Institute of Malaga (IBIMA), REDinREN (RD16/0009/0006), Malaga, Spain
| | | | | | - Casilda Olveira
- Pneumology Service. Regional University Hospital of Malaga. Institute for Research in Biomedicine IBIMA (Malaga). University of Malaga. Malaga, Spain
| | - Pedro Valdivielso
- Internal Medicine, Clinical Hospital Universitario Virgen de la Victoria, Dept of Medicine and Dermatology and Biomedical Research Institute of Malaga (IBIMA), University of Malaga, Malaga, Spain.
| | - Miguel Ángel Sánchez-Chaparro
- Internal Medicine, Clinical Hospital Universitario Virgen de la Victoria, Dept of Medicine and Dermatology and Biomedical Research Institute of Malaga (IBIMA), University of Malaga, Malaga, Spain
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