title: Subclinical Carotid Atherosclerosis in COPD Cases and Control Smokers: Analysis in Relation with COPD Exacerbations and Exacerbation-like Episodes.
abstract: It remains unclear whether there is a pathogenic link between chronic obstructive pulmonary disease (COPD) and cardiovascular diseases. Subclinical carotid atherosclerosis is a predictor of future cardiovascular events. Exacerbations increase all-cause mortality in COPD, and exacerbation-like episodes have been described in subjects without COPD. Our objectives were as follows: (1) to confirm the independent association between COPD and carotid atherosclerosis and (2) to asses the possible relationship between COPD exacerbations or exacerbation-like episodes and a higher risk of atherosclerosis.
  
  
  
  127 COPD subjects and 80 control subjects with smoking history were studied. Carotid ultrasound examination was carried out in all subjects. Univariate and multivariate logistic regression analyses were performed in order to assess the relationship between both COPD diagnosis and previous COPD exacerbations (or exacerbation-like episodes in non-COPD subjects) and the presence of carotid atherosclerosis.
  
  
  
  The prevalence of carotid atherosclerosis was higher in COPD group (65.3 vs. 47.5%, p = 0.01; OR 2.18, 95% CI 1.23-3.88, p < 0.01). Diagnosis of COPD was not independently associated with atherosclerosis, after adjusting for potential confounders. Neither COPD exacerbations nor exacerbation-like episodes in control subjects were associated with a higher risk of atherosclerosis.
  
  
  
  There is a higher prevalence of carotid atherosclerosis in COPD than in control smokers or ex-smokers, but the differences seem to be related to shared risk factors. We have not found evidence for an increased risk of atherosclerosis associated with COPD exacerbations or exacerbation-like events. Further longitudinal studies should be carried out to confirm these findings.
authors.affiliation: Respiratory Service, Servicio de Neumología. Unidad Administrativa 4-A, Hospital Universitario Lucus Agusti, C/ Dr Ulises Romero no 1, 27003, Lugo, Spain. rafagolpe@gmail.com.
authors.forename: Rafael
authors.initials: R
authors.lastname: Golpe
authors.affiliation: Internal Medicine Service, Hospital Universitario Lucus Agusti, Lugo, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Mateos-Colino
authors.affiliation: Cardiology Service, Hospital Universitario Lucus Agusti, Lugo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: González-Juanatey
authors.affiliation: Cardiology Service, Hospital Universitario Lucus Agusti, Lugo, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Testa-Fernández
authors.affiliation: Internal Medicine Service, Hospital Universitario Lucus Agusti, Lugo, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Domínguez-Pin
authors.affiliation: EOXI Lugo, Cervo e Monforte de Lemos, Servizo Galego de Saúde, Lugo, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Martín-Vázquez
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D012907:Smoking / Q000453:epidemiology; D000067251:Symptom Flare Up
keywords: COPD exacerbation; Cardiovascular diseases; Carotid atherosclerosis; Chronic obstructive; Pulmonary disease; Tobacco