Factors associated with coronary heart disease in COPD patients and controls
Christina D. Svendsen, Karel K. J. Kuiper, Kristoffer Ostridge, Terje H. Larsen, Rune Nielsen, Vidar Hodneland, Eli Nordeide, Per S. Bakke, Tomas M. Eagan
Abstract
COPD and coronary heart disease (CHD) frequently co-occur, yet which COPD phenotypes are most prone to CHD is poorly understood. The aim of this study was to see whether COPD patients did have a true higher risk for CHD than subjects without COPD, and to examine a range of potential factors associated with CHD in COPD patients and controls.
Background
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and includes phenotypic traits such as emphysema, exacerbation frequency, and respiratory failure. The rate of progression of COPD is heterogeneous, varying greatly between and within afflicted individuals. Many patients exhibit significant comorbidities, among them coronary heart disease (CHD), accompanied by both a high symptom burden and mortality [1,2]. Numerous previous studies have established that CHD is more common in COPD patients than in the general population [3–8]. Cardiovascular disease is the leading cause of death in COPD patients [9].
Methods
Study population and design
The participants were recruited as a cross-sectional sample from two previous patient-control cohorts: The MicroCOPD study and the follow-up phase of the GeneCOPD study. The MicroCOPD Study was conducted 2012–2015 [15], and included 16 asthma patients whom were excluded from the current study, whereas the GeneCOPD follow-up 2013–2016 only included COPD patients and controls from the first GeneCOPD study in 2003–2004 [16].
In the original GeneCOPD study in 2003–2006, only half of the participants had pulmonary CT scans taken
Results and Discussion
Table 2 shows the study characteristics of the COPD and control subjects. Mean age among COPD patients and controls were 69.0 years (SD 7.9) and 64.8 years (SD 8.5) respectively. The COPD patients were older, less likely to have a normal body composition, had smoked more frequently and a larger load, and were more likely to use both cholesterol and blood pressure lowering drugs than control subjects.
Discussion
In this study of both COPD patients and non-COPD controls who underwent pulmonary CT imaging and CCTA, we confirmed the increased presence of coronary artery disease in COPD patients. After adjustment for potential confounders, COPD patients had significantly higher odds for having an increased calcium score. However, in the same multivariable analyses, age, male sex, and CRP ≥5 was significantly associated with having significant coronary stenosis, and age, male sex and statin use for increased calcium score.
Citation: Svendsen CD, Kuiper KKJ, Ostridge K, Larsen TH, Nielsen R, Hodneland V, et al. (2022) Factors associated with coronary heart disease in COPD patients and controls. PLoS ONE 17(4): e0265682. https://doi.org/10.1371/journal.pone.0265682
Editor: Kjell Torén, University of Gothenburg: Goteborgs Universitet, SWEDEN
Received: November 7, 2021; Accepted: March 4, 2022; Published: April 27, 2022
Copyright: © 2022 Svendsen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data relevant for this study are available on Dryad at: https://doi.org/10.5061/dryad.2fqz612r4.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: COPD, chronic obstructive pulmonary disease; CHD, coronary heart disease; CCTA, coronary computed tomography angiography; CaSc, calcium score; ACE, angiotensin converting enzyme; ARBs, angiotensin receptor blockers; FVC, Forced vital capacity; FEV1, forced expiration volume in 1 second; FMI, fat mass index; FFMI, fat free mass index; GFR, glomerular filtration rate; OR, odds ratio; SD, standard deviation.
