Faculty of Medicine
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Item type:Publication, COPD as a risk factor for carotid artery disease (CAD) and low-extremity artery disease (LEAD)(European Respiratory Society, 2020-09-07); ; ;Kochovska Kamchevska, Nade ;Baloski, MarjanPoposki, BozidarWe aimed to investigate the association between COPD and peripheral artery disease (PAD), the relation to the severity of airflow limitation and the level of serum C-reactive protein (CRP). Cross-sectional study including 120 patients with initially diagnosed COPD, aged 40 to 75 years and 60 non-COPD subjects matched by age, smoking status, body mass index, as controls. All study participants underwent pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, chest X-ray), Doppler ultrasonography and measurement of serum CRP. Results presented statistically significant difference in presence of LEAD in COPD patients compared to controls (78.3% vs 38.3%; P<0.001). According to the Fontaine classification, COPD patients with LEAD were categorized in stages I, IIA and IIB (60%, 30% and 15%, respectively), whereas all controls with LEAD were in the Fontaine stage I. COPD patients with LEAD presented significant association between disease severity and clinical manifestations due to the vascular changes (P=0.001) and CRP (P<0.05). Comparison between presence of CAD in COPD and controls showed statistical significance (70% vs 36%; P < 0.0001). The mean value of intima-media thickness (IMT) in COPD patients with CAD was significantly higher than its mean value in controls (0.8 ± 0.2 vs. 0.6 ± 0.1; P=0.0043). IMT value in COPD patients with CAD was significantly related to FEV1 decline (P=0.000) and CRP (P=0.001). We found higher prevalence and severity of PAD in COPD patients compared to non-COPD and significant relation to FEV1 decline and serum CRP. Our findings suggest a need for early screening for PAD in COPD and an integrated-care approach.
