title: Chronic obstructive pulmonary disease and lipid core carotid artery plaques in the elderly: the Rotterdam Study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is an independent risk factor for ischemic stroke and the risk increases with severity of airflow limitation. Even though vulnerable carotid artery plaque components, such as intraplaque hemorrhage and lipid core, place persons at high risk for ischemic events, the plaque composition in patients with COPD has never been explored.
  
  
  OBJECTIVE
  To investigate the prevalence of carotid wall thickening, the different carotid artery plaque components, and their relationship with severity of airflow limitation in elderly patients with COPD.
  
  
  METHODS
  This cross-sectional analysis was part of the Rotterdam Study, a prospective population-based cohort study performed in subjects aged 55 years and older. Diagnosis of COPD was confirmed by spirometry. Participants with carotid wall intima-media thickness greater than or equal to 2.5 mm on ultrasonography underwent high-resolution magnetic resonance imaging for characterization of carotid plaques. Data were analyzed using logistic regression.
  
  
  RESULTS
  COPD cases (n = 253) had a twofold increased risk (odds ratio, 2.0; 95% confidence interval, 1.44-2.85; P < 0.0001) of presentation with carotid wall thickening on ultrasonography compared with control subjects with a normal lung function (n = 920). Moreover, the risk increased significantly with severity of airflow limitation. On magnetic resonance imaging, vulnerable lipid core plaques were more frequent in COPD cases than in control subjects (odds ratio, 2.1; 95% confidence interval, 1.25-3.69; P = 0.0058).
  
  
  CONCLUSIONS
  Carotid artery wall thickening is more prevalent in patients with COPD than in control subjects. In elderly subjects with carotid wall thickening, COPD is an independent predictor for the presence of a lipid core, and therefore of vulnerable plaques.
authors.affiliation: Department of Respiratory Medicine, Ghent University, Ghent University Hospital, Belgium.
authors.forename: Lies
authors.initials: L
authors.lastname: Lahousse
authors.forename: Quirijn J A
authors.initials: QJ
authors.lastname: van den Bouwhuijsen
authors.forename: Daan W
authors.initials: DW
authors.lastname: Loth
authors.forename: Guy F
authors.initials: GF
authors.lastname: Joos
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.forename: Guy G
authors.initials: GG
authors.lastname: Brusselle
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001991:Bronchitis; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008055:Lipids / Q000737:chemistry*; D008279:Magnetic Resonance Imaging; D009426:Netherlands; D058226:Plaque, Atherosclerotic / Q000145:classification* / Q000000981:diagnostic imaging / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D013147:Spirometry; D014463:Ultrasonography; D014797:Vital Capacity
chemical_list: D008055:Lipids