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Severity of coronary atherosclerosis in patients with COPD
Neşe Dursunoglu1, Dursun Dursunoglu2, Ali İhsan Yıldız1
1Departments of Chest, Pamukkale University Medical Faculty, Denizli, Turkey.
Insights
Chronic obstructive pulmonary disease (COPD) is linked to more severe coronary artery disease. As COPD severity increases, so does the extent of coronary artery narrowing.
Area of Science:
- Cardiology and Pulmonology
- Systemic Inflammation and Oxidative Stress
- Atherosclerosis Research
Background:
- Chronic obstructive pulmonary disease (COPD) is a significant comorbidity with coronary artery disease (CAD).
- Systemic inflammation and oxidative stress are implicated in the pathogenesis of both COPD and CAD.
- Understanding the relationship between COPD severity and CAD burden is crucial for patient management.
Purpose of the Study:
- To investigate the impact of COPD severity on the intensity and extent of coronary artery lesions.
- To analyze coronary artery disease (CAD) severity in patients with varying grades of chronic obstructive pulmonary disease (COPD).
- To determine if COPD severity, categorized by Global Initiative for Obstructive Lung Disease (GOLD) grades, correlates with coronary atherosclerosis.
Main Methods:
- Coronary angiography was performed on 102 COPD patients and 80 controls.
- COPD patients were stratified into four groups (A, B, C, D) based on 2015 GOLD guidelines.
- Coronary artery disease (CAD) severity was quantified using the Gensini score.
Main Results:
- COPD patients exhibited significantly higher Gensini scores compared to controls (25.7 vs. 17.5, P=0.01).
- Gensini scores demonstrated a positive correlation with GOLD grades, increasing from group A (10.2) to group D (64.9).
- COPD was identified as an independent predictor of Gensini score (OR 1.374, P=0.001).
Conclusions:
- Coronary atherosclerosis severity and intensity increase progressively with GOLD grades in COPD patients.
- The findings highlight a direct relationship between the severity of chronic obstructive pulmonary disease and the burden of coronary artery disease.
- COPD severity is a significant independent risk factor for more intense coronary artery lesions.
Background And Aims:
Chronic obstructive pulmonary disease (COPD) has many comorbidities such as coronary artery disease (CAD) and stroke. Chronic low-grade systemic inflammation and oxidative stress play a significant role in CAD and COPD. We analysed that impact of COPD on intensity and severity of coronary artery lesions on the angiogram in the groups of patients with COPD according to the Global Initiative for Obstructive Lung Disease (GOLD) grades updated in 2015.
Methods:
The study included 102 COPD patients and 80 randomly selected subjects without any pulmonary disease who underwent coronary angiography. According to the GOLD grade for COPD, patients were divided into four groups: A, B, C and D. The severity and extent of CAD were determined using the Gensini score.
Results:
There were no significant between-group differences in age, body mass index, smoking history, plasma lipids levels, frequency of hypertension, diabetes and CAD. The mean Gensini score in patients with COPD was significantly higher than those without (respectively, 25.7 ± 32.9 vs 17.5 ± 24.8, P = 0.01). While Gensini score was the highest level in the patient group D (64.9 ± 34.9), it was the lowest level in the patient group A (10.2 ± 19.4, P = 0.0001). The Gensini scores increased in accordance with increases in the GOLD grades. We observed that COPD was independently predictive for Gensini score after a multi-variate logistic regression analysis (odds ratio 1.374; 95% confidence interval 1.672-9.232; P = 0.001).
Conclusion:
Severity and intensity of coronary atherosclerosis increases in accordance with increases in the GOLD grades for COPD.
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