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[Prevalence of Peripheral Arterial Disease in Patients with COPD Depending on Disease Stage, Systemic Inflammation,
Alexander Rech1, Nina R Schwarzbach2, Eva Lücke3
1Praxis Rech, Pneumologie, Niedersachsen, Deutschland, Braunschweig.
Background:
Chronic obstructive pulmonary disease (COPD) is frequently associated with cardiovascular comorbidities, including peripheral arterial disease (PAD). The aim of this study was to assess, under real-life conditions in a general practice with a pulmonology focus, the prevalence of PAD in patients with COPD and to analyze the association between exacerbation frequency and severity and the ankle-brachial index (ABI).
Methods:
In this retrospective, single-center, cross-sectional observational study, 181 patients with COPD were investigated. In addition to clinical parameters and exacerbation history over the preceding 12 months, the ABI, six-minute walk distance, and inflammatory markers (high-sensitivity C-reactive protein [hs-CRP] and fibrinogen) were assessed. An ABI <0,9 was considered indicative of PAD.
Results:
A pathological ABI consistent with PAD was observed in 25 patients (13.8%). Both exacerbation frequency and, in particular, exacerbation severity were significantly associated with lower ABI values. Patients with one or more exacerbations had significantly lower ABI values compared with patients without exacerbations. Current smokers exhibited overall lower ABI values than never-smokers; however, the association between exacerbations and ABI was also evident in never-smokers. After adjustment, no independent associations were observed between systemic inflammatory markers, including hs-CRP and fibrinogen, and ABI.
Conclusions:
PAD represents a frequent comorbidity in patients with COPD. A higher exacerbation burden is associated with lower ABI values and thus with an increased risk of PAD, even after adjustment for classical risk factors. These findings highlight the value of ABI measurement as a simple, non-invasive screening tool in patients with COPD, particularly in those with frequent or severe exacerbations.
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