Subclinical carotid atherosclerosis in patients with chronic obstructive pulmonary disease: a meta-analysis of literature studies.
Chronic obstructive pulmonary disease (COPD) patients have an increased cardiovascular (CV) morbidity and mortality. Common carotid intima-media thickness (CCA-IMT) and carotid plaques are surrogate markers of subclinical atherosclerosis and predictors of CV events.



We performed a meta-analysis to evaluate the association between COPD and subclinical atherosclerosis. Studies evaluating the impact of COPD on CCA-IMT and on the prevalence of carotid plaques were systematically searched.



Twenty studies (2082 COPD patients and 4844 controls) were included, 12 studies with data on CCA-IMT (13 data-sets on 1180 COPD patients and 2312 controls) and 12 studies reporting on the prevalence of carotid plaques (1231 COPD patients and 4222 controls). Compared to controls, COPD patients showed a significantly higher CCA-IMT (mean difference [MD]: 0.201 mm; 95%CI: 0.142, 0.260; p < .001), and an increased prevalence of carotid plaques (Odds Ratio [OR]: 2.503; 95%CI: 1.333, 2.175; p < .0001). Meta-regression models showed a direct association between disease severity [as expressed by Global Initiative for Chronic Obstructive Lung Disease (GOLD) class] and the difference in the risk of carotid plaques presence between COPD patients and controls.



COPD is significantly associated with subclinical atherosclerosis. These findings may be useful to plan adequate CV prevention strategies. Key messages COPD patients show a higher CCA-IMT and an increased prevalence of carotid plaques compared with controls. A more severe pulmonary disease is associated with a higher prevalence of carotid plaques in COPD patients. Screening for subclinical atherosclerosis may be worthy in COPD patients to plan specific prevention strategies.
a Department of Clinical Medicine and Surgery , Federico II University , Naples , Italy.|b ICS Maugeri SpA SB, Scientific Institute of Telese Terme - IRCCS , Telese Terme (BN) , Italy.
Pasquale
P
Ambrosino
a Department of Clinical Medicine and Surgery , Federico II University , Naples , Italy.
Roberta
R
Lupoli
a Department of Clinical Medicine and Surgery , Federico II University , Naples , Italy.
Giovanni
G
Cafaro
b ICS Maugeri SpA SB, Scientific Institute of Telese Terme - IRCCS , Telese Terme (BN) , Italy.
Salvatore
S
Iervolino
c ICS Maugeri SpA SB, Scientific Institute of Cassano delle Murge - IRCCS , Cassano delle Murge (BA) , Italy.
Mauro
M
Carone
b ICS Maugeri SpA SB, Scientific Institute of Telese Terme - IRCCS , Telese Terme (BN) , Italy.
Nicola
N
Pappone
d Department of Advanced Biomedical Sciences, Division of Cardiology , Federico II University , Naples , Italy.
Matteo Nicola Dario
MND
Di Minno
D000368:Aged; D015415:Biomarkers / Q000032:analysis; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012044:Regression Analysis; D012307:Risk Factors
D015415:Biomarkers
Chronic obstructive pulmonary disease; carotid plaques; intima-media thickness; subclinical atherosclerosis