title: Subclinical atherosclerotic vascular disease in chronic obstructive pulmonary disease: Prospective hospital-based case control study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is an important non-communicable disease worldwide with a rising global incidence. COPD is associated with multiple co-morbidities. Patients with COPD are at increased risk of atherosclerosis and other cardiovascular events. Cardiovascular diseases are an important cause of morbidity and mortality in COPD. The present case-control study was designed to assess the relationship between sub-clinical atherosclerotic vascular diseases with COPD.
  
  
  METHODS
  It was a prospective case-control blinded observational study. There were 142 COPD patients and 124 age-and sex-matched controls without COPD and cardiovascular diseases. Frequency of sub-clinical atherosclerosis was assessed by the carotid B-mode duplex ultrasonography assessment of carotid wall intima medial thickness (IMT). Plaque was defined as IMT of more than 1.2 mm.
  
  
  RESULTS
  Prevalence of carotid plaqing was significantly higher amongst patients of COPD (38.7%) compared to controls (13.7%, odds ratio 3.9, P < 0.0001). Multinomial logistic regression analysis revealed COPD as an independent predictor of carotid plaqing (r = 0.85, P < 0.023).
  
  
  CONCLUSIONS
  The frequency of carotid plaqing is high in COPD patients. Carotid plaqing may be due to shared risk factors or the presence of low-grade systemic inflammation. Presence of increased CIMT and carotid plaqing in COPD patients identifies early atherosclerotic changes and future cardiovascular risk. Hence screening of CIMT should be a part of cardiovascular assessment in patients with COPD.
authors: Department of General Medicine, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India.
authors: Sandip
authors: S
authors: Chindhi
authors: Department of Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors: Surinder
authors: S
authors: Thakur
authors: Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors: Malay
authors: M
authors: Sarkar
authors: Department of Cardiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors: Prakash C
authors: PC
authors: Negi
keywords: Carotid wall intima medial thickness; Chronic obstructive pulmonary disease; subclinical atherosclerosis