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Traditional and emerging indicators of cardiovascular risk in chronic obstructive pulmonary disease

John, Michelle; McKeever, Tricia M.; Haddad, Maath Al; Hall, Ian P.; Sayers, Ian; Cockcroft, John R.; Bolton, Charlotte E.

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Authors

Michelle John

Tricia M. McKeever

Maath Al Haddad

Ian P. Hall

John R. Cockcroft

Charlotte E. Bolton



Abstract

With the increased cardiovascular (CV) morbidity and mortality in subjects with chronic obstructive pulmonary disease (COPD), there is a priority to identify those patients at increased risk of cardiovascular disease. Stable patients with COPD (n = 185) and controls with a smoking history (n = 106) underwent aortic pulse wave velocity (PWV), blood pressure (BP) and skin autofluorescence (AF) at clinical stability. Blood was sent for fasting lipids, soluble receptor for advanced glycation end products (sRAGE) and CV risk prediction scores were calculated. More patients (18%) had a self-reported history of CV disease than controls (8%), p = 0.02, whilst diabetes was similar (14% and 10%), p = 0.44. Mean (SD) skin AF was greater in patients: 3.1 (0.5) AU than controls 2.8 (0.6) AU, p < 0.001. Aortic PWV was greater in patients: 10.2 (2.3) m/s than controls: 9.6 (2.0) m/s, p = 0.02 despite similar BP. The CV risk prediction scores did not differentiate between patients and controls nor were the individual components of the scores different. The sRAGE levels were not statistically different. We present different indicators of CV risk alongside each other in well-defined subjects with and without COPD. Two non-invasive biomarkers associated with future CV burden: skin AF and aortic PWV are both significantly greater in patients with COPD compared to the controls. The traditional CV prediction scores used in the general population were not statistically different. We provide new data to suggest that alternative approaches for optimal CV risk detection should be employed in COPD management.

Citation

John, M., McKeever, T. M., Haddad, M. A., Hall, I. P., Sayers, I., Cockcroft, J. R., & Bolton, C. E. (2016). Traditional and emerging indicators of cardiovascular risk in chronic obstructive pulmonary disease. Chronic Respiratory Disease, 13(3), https://doi.org/10.1177/1479972316636995

Journal Article Type Article
Acceptance Date Jan 8, 2016
Online Publication Date Mar 10, 2016
Publication Date Aug 1, 2016
Deposit Date Jan 27, 2017
Publicly Available Date Jan 27, 2017
Journal Chronic Respiratory Disease
Print ISSN 1479-9723
Electronic ISSN 1479-9731
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 13
Issue 3
DOI https://doi.org/10.1177/1479972316636995
Keywords Cardiovascular risk, COPD, Advanced glycation end products, Aortic stiffness, Autofluorescence
Public URL https://nottingham-repository.worktribe.com/output/797624
Publisher URL http://journals.sagepub.com/doi/abs/10.1177/1479972316636995

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