Older COPD Patients have an Elevated Risk for Carotid Atherosclerosis
A new clinical study from the Netherlands has shown that older COPD patients have an increased risk of developing plaque build-up in the carotid artery, as well as potentially having vulnerable plaques containing a lipid core.
Health care providers were already aware that patients with chronic obstructive pulmonary disease (COPD) have a higher risk of suffering an ischemic stroke (in fact, COPD is viewed as an independent risk factor for stroke). It is also known that there are certain aspects of carotid artery plaques, such as a lipid core and intraplaque hemorrhage, which can further increase the risk of certain ischemic events.
On the other hand, the composition of plaque in patients with COPD had not yet been studied.
COPD vs. Normal Lung Function
In this latest COPD clinical trial, researchers found that older COPD patients had carotid artery walls that were twice as thick as that which was measured in the control group with normal lung function. The research team also found that the presence of COPD on its own seemed to predict the presence of plaques containing a lipid core (these tend to have a higher chance of rupturing).
This latest clinical research was actually a part of the Rotterdam Study, an ongoing population-based cohort trial which is trying to accurately determine the rate of occurrence and risk factors for chronic diseases among study participants who are older than 54 years.
The lead investigators for this cross-sectional study used 253 COPD patients and 920 controls (all COPD patients tested in this trial had to have their diagnosis confirmed by spirometry). For all the participants in whom they found carotid wall thickening, the research team took high-resolution MRI’s in order to accurately characterize the carotid plaques.
Determining the Results of this COPD Clinical Study
Ultrasonography showed that the subjects with COPD had about a two times higher risk of carotid wall thickening than the controls, and this risk was significantly impacted by the severity of airflow limitation. According to the MRI results, the vulnerable lipid core plaques also appeared to be much more frequent among the participants with COPD than the controls.
With the results of this COPD clinical study, health care providers should now be aware that COPD patients have an elevated risk for carotid atherosclerosis. Plus, this disease could aggravate or induce the presence of plaques containing a lipid core which might cause them to become more vulnerable.
Some Minor Shortcomings….
Unfortunately, there were a few limitations in this clinical trial, which the medical researchers were forced to work around. For one thing, the cross-sectional design of the study did not allow the team to deduce the causal associations between COPD and carotid plaques, and then there was a lack of computed tomography confirmation for emphysema.
In the end, the results of this COPD research has provided valuable new insight into the relationship that exists between this disease and the elevated risk for stroke that has been recorded in these patients. By better understanding the underlying risk factors for stroke in COPD patients, health care providers will be able to accurately identify those people who may be at high risk. Not to mention, that further application of this COPD clinical research will lead to better forms of preventative therapeutic strategies which can directly target this devastating condition.