Faculty of Medicine

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Author: search.filters.author.Kochovska Kamchevska NadeSubject: search.filters.subject.COPD

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    COPD as a risk factor for Coronary Artery Disease (CAD): Overview of 10-year atherosclerotic cardiovascular disease (ASCVD) risk assessment
    (2022-12-01)
    ;
    Mickovski Ivana
    ;
    Baloski Marjan
    ;
    Doneva Daniela
    ;
    Neshovska Radmila
    We aimed to investigate the association between COPD and CAD (overview of 10-year risk of fatal cardiovascularevent), and the relation to the severity of airflow limitation.Cross-sectional study including 220 patients with stable COPD as investigated group (IG), aged 40 to 75 yearsand 58 non-COPD subjects, matched by gender, age, BMI, smoking status, as control group (CG). All studysubjects underwent pulmonary, cardiological evaluation, lipid and glycemic status.The analysis compared the 10-year established ASCVD risk between COPD stages (according to GOLDclassification 1, 2, 3, 4) and between IG vs. CG. ASCVD score was classified as low (score <5%), borderline (5 to<7.5%), moderate (≥7.5 to <20) and high risk (score ≥20%). Results presented statistically significant differencebetween mean ASCVD value in IG 21,69±13,86% vs. CG 15,83±9,92% (p=0.0028). The median risk of ASCVDfor fatal cardiovascular events was high in IG and moderate in CG. The mean and median values of 10-yearASCVD risk in the IG subgroups were: GOLD1 16,79±8,04% (50% of the subjects with risk >15,7%), GOLD222,67±16,49% (50% of the subjects with risk >20,6%), GOLD3 26,81±14,15% (50% of the subjects with risk >27,6%) and GOLD4 20,70±13,52% (50% of the subjects with risk > 18,4%). The average ASCVD risk of fatalcardiovascular event was moderate in GOLD1 and GOLD4, and high in GOLD2 and GOLD3.We found higher risk for fatal cardiovascular outcome in patients with COPD, even in the early COPD stages(GOLD2), compared to non-COPD group. Our findings suggest that an urgent need to develop comprehensivestrategies for prevention, screening and early treatment are needed.
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    LOW-GRADE SYSTEMIC INFLAMMATION IN PATIENTS WITH STABLE CHRONIC OBSTRUCTIVE PULMONARY DISEASE
    (Association of pulmologists from Republika Srpska, 2019-05)
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    ;
    Kochovska Kamchevska Nade
    ;
    Bushev Jane
    Introduction: Chronic obstructive pulmonary disease (COPD) is a multicomponent disease with extrapulmonary effects. Systemic aspects of COPD include oxidative stress and altered circulating levels of inflammatory mediators and acute-phase proteins. Airflow limitation is associated with an abnormal inflammatory response mainly initiated by smoke inhalation. Even though chronic inflammation is a characteristic phenomenon of the disease, so far little is known about underlying pathogenetic mechanisms. Aim: To evaluate circulating C-reactive protein (CRP) level as a biomarker of systemic inflammation, leukocyte count, lipid profile and smoking exposure in patients with stable COPD and their correlation with the severity of the disease. Material and methods: Cross sectional study was conducted at 60 patients with COPD (age 40-75) and 30 subjects from general population without COPD, matched by age, gender and body mass index. All patients underwent laboratory testing and pulmonary function tests. The severity level in patients with COPD was determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria. Results: We found statistically significant difference between mean serum CRP level in stable COPD than control group (10.2 vs. 5.9, P = 0.04, P< 0.05). The Pearson correlation between leukocytes count and CRP value in stable COPD patients, compared to control group, showed statistically significant correlation (r=0.358, P=0.005, P < 0.01). According to lipid profile, comparison was made between mean values of total cholesterol, triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) in both groups, but statistically significant difference was not found. Number of patients with leukocyte count >109/L was significantly higher in stable COPD than control group (45% vs. 26.7%, P= 0.01, P < 0.05). The degree of airflow limitation in COPD patients was significantly related to smoking exposure expressed by number of pack-years (Brinkman Index), Pearson correlation, (r= -0.525, P=0.000, P < 0.01), as well as to the serum CRP level (r= -0.324, P=0.012, P < 0.05). Conclusion: The present study confirms that circulating CRP levels and total leukocyte count are higher in stable COPD patients. Serum CRP may be regarded as a valid biomarker of low-grade systemic inflammation which is the leading point to atherosclerosis.