engleski

Aortic stiffness, cardiovascular risk score and inflammatory biomarkers in patients with COPD

AIMS AND OBJECTIVES are to determine if patients with COPD, without documented comorbidities, have different SCORE and determinants of AS, as well as levels of inflammatory biomarkers compared to control groups of apparently healthy smokers and nonsmokers. Additional aim was to test the relationship between levels of obstruction and different grades of COPD with variables of arterial stiffness. METHODS Cross-sectional study in 2017 included 61 COPD patients, 83 non-COPD smokers and 65 non-COPD nonsmokers without previous comorbidities. After medical history, physical examination and spirometry, COPD was evaluated by GOLD guidelines. Patients in COPD group were divided by level of obstruction and grade using GOLD ABCD tool. Oscillometric device and software were used to assess aortic pulse wave velocity (PWVao) noninvasively. After examination and blood sampling, SCORE was calculated with high-risk chart for Croatia. Statistical analysis used Kolmogorov-Smirnov Test, Oneway ANOVA, Pearson correlation coefficient and Spearman's rank correlation coefficient. CONCLUSION Patients with COPD have higher AS and ultimately elevated CV risk compared to non-COPD controls of smokers and nonsmokers. These results add to the pool of evidence that COPD, independently of smoking, contributes to pathogenesis of atherosclerosis. Subjects with COPD have higher CV risk, measured by SCORE value, compared to non-COPD controls. AS is associated with SCORE. Critical PWVAO of 10 m/s is achieved already in the SCORE calculation of 4%. Both AS and SCORE results are related to levels of hs-CRP and fibrinogen. Results support evidence that AS, as well as biomarkers, could be useful in practice to determine CV risk in COPD patients. Patients with higher level of obstruction and higher grade of disease have significantly higher SCORE result and are more likely to have a fatal CV disease in next 10 years. COPD patients with higher levels of obstruction have higher AS. Critically elevated PWVAO can be measured already at obstruction level 1 and rises for 0.92 m/s for every further level. This finding has significant implication for CV risk assessment in COPD patients.

aortic stiffness, cardiovascular risk, inflammatory biomarkers, COPD

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