TITLE:
Leg Atherosclerosis in Japanese COPD Patients: Prevalence of Undiagnosed Peripheral Artery Disease and Association between Leg Atherosclerosis and Clinical Indices
AUTHORS:
Hirofumi Matsuoka, Yusuke Matsumoto, Kengo Kimura, Midori Koyama, Towa Uzu, Yasuko Koma, Kensuke Fukumitsu, Yoshitaka Kasai, Nariyasu Nakashima, Daiki Masuya, Harukazu Yoshimatsu, Yujiro Suzuki
KEYWORDS:
COPD; Peripheral Artery Disease; Leg Atherosclerosis; Ankle-Brachial Index
JOURNAL NAME:
Open Journal of Respiratory Diseases,
Vol.3 No.1,
February
25,
2013
ABSTRACT: Introduction: Several
studies have suggested that decreased FEV1 is associated with cardiovascular
risk in COPD patients. Objective: To
identify the prevalence of undiagnosed peripheral artery disease (PAD) and the relationship between
leg atherosclerosis and clinical indices, which predict COPD mortality in Japanese COPD patients. Methods: We performed a cross-sectional
study in 51 COPD patients and 51 age-matched, healthy control smokers. We measured
ankle-brachial index (ABI) as a marker of atherosclerosis of the legs, pulmonary
function, body mass index, modified Medical Research Council (MMRC) dyspnea scale,
and smoking pack-years. We also calculated the ADO index (Age, Dyspnea, and Obstruction),
an established predictor of mortality in COPD patients. Co-morbidities including
diabetes mellitus, hypertension, and hypercholesterolemia were identified from blood
laboratory tests and medical records. Results: Five subjects (9.8%) had an ABI 0.9. ABI was significantly lower in the COPD patients than
in the healthy control smokers (p 0.05). The prevalence
of PAD was marginally higher in COPD patients than in control smokers (p = 0.09), with the prevalence of ABI 1.0 being significantly
higher in COPD patients than in control smokers (p = 0.04). In the COPD patients,
ABI showed significant correlations with age (p = 0.006), FEV1 (p = 0.004), smoking pack-years (p = 0.047), MMRC dyspnea scale
(p = 0.0005), SaO2 (p = 0.001), andADOindex (p 0.001). Multiple linear regression modeling showed the
factors associated independently with ABI were age, FEV1, smoking pack-years,
MMRC dyspnea scale, and SaO2. Conclusion: The risk of leg atherosclerosis in Japanese COPD patients
is higher than in smokers without COPD. Leg atherosclerosis in COPD patients is
associated with clinical indices that predict COPD mortality.