Atherosclerosis is Associated Comorbidity in Patients with Chronic Obstructive Pulmonary Disease: Ultrasound Assessment of Carotid Intima Media Thickness

Objective: To assess atherosclerotic comorbidity in chronic obstructive pulmonary disease (COPD) patients and its relationship to COPD severity, hypoxemia, and hypercapnia.
Methods: A hospital-based observational case-control study was conducted on 86 male COPD patients, and 86 age-matched healthy subjects (non-COPD group). Carotid intima-media thickness (CIMT) was assessed by Doppler ultrasound; in addition, spirometry and arterial blood gas tests were done.
Results: CIMT was significantly increased in the COPD group compared to the non-COPD group (0.84±0.15 vs. 0.63±0.076, p<0.001). When the CIMT value of ≥0.8 mm was defined as a cutoff value for a thickened CIMT complex, 64% of COPD patients versus 8.1% of non-COPD subjects had a thickened CIMT. COPD patients with a thickened CIMT were older and had a higher PaCO2, lower FEV1%, FVC, and FEF25–75% compared to COPD patients with a normal CIMT. Thickened CIMT in COPD patients was significantly associated with hypoxemia (p=0.008, OR=8.2), hypercapnia (p=0.04, OR=6.2), and airflow limitation (p=0.11, OR=2.1). There was no significant difference in CIMT in relation to COPD severity (p=0.83).
Conclusion: Atherosclerosis is prevalent in COPD patients, even in the early stages of the disease. Hypoxemia, hypercapnia, and airflow limitation are risk factors of atherosclerosis in COPD patients.