title: Relationship between chronic obstructive pulmonary disease and subclinical coronary artery disease in long-term smokers.
abstract: OBJECTIVE
  Cardiovascular conditions are reported to be the most frequent cause of death in patients with chronic obstructive pulmonary disease (COPD). However, it remains unsettled whether severity of COPD per se is associated with coronary artery disease (CAD) independent of traditional cardiovascular risk factors. The aim of this study was to examine the relationship between the presence and severity of COPD and the amount of coronary artery calcium deposit, an indicator of CAD and cardiac risk, in a large population of current and former long-term smokers.
  
  
  RESULTS
  In this cross-sectional study, long-term smokers without clinically manifested CAD were recruited from the Danish Lung Cancer Screening Trial and classified according to lung function by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Coronary artery calcium deposit as a measure of subclinical CAD and cardiac risk was evaluated with multi detector computed tomography and the Agatston coronary artery calcium score (CACS). Participants were categorized into five CACS risk classification groups according to the CACS. The population (n = 1535) consisted of 41% participants without COPD, 28% with mild, and 31% with moderate-to-severe COPD (n = 46 with severe COPD). In addition to age, male gender, hypertension, hypercholesterolaemia, and continued smoking, COPD according to GOLD classification were independent predictors of a higher CACS risk classification group in multivariable analysis [odds ratio (OR): 1.28 (1.01-1.63) and OR: 1.32 (1.05-1.67), for mild and moderate-to-severe COPD, respectively, compared with no COPD].
  
  
  CONCLUSIONS
  COPD in long-term smokers is independently correlated with the CACS, while COPD severity per se does not show a dose-response relationship.
authors: Department of Cardiology, Section 2012, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark.
authors: Thomas
authors: T
authors: Rasmussen
authors: Lars
authors: L
authors: Køber
authors: Jesper Holst
authors: JH
authors: Pedersen
authors: Asger
authors: A
authors: Dirksen
authors: Laura Hohwü
authors: LH
authors: Thomsen
authors: Steen
authors: S
authors: Stender
authors: John
authors: J
authors: Brodersen
authors: Jaap
authors: J
authors: Groen
authors: Haseem
authors: H
authors: Ashraf
authors: Klaus Fuglsang
authors: KF
authors: Kofoed
mesh_terms: D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D016019:Survival Analysis; D013997:Time Factors
keywords: Chronic obstructive pulmonary disease; Coronary artery calcium score; Risk assessment; Smoking