Leg Atherosclerosis in Japanese COPD Patients: Prevalence of Undiagnosed Peripheral Artery Disease and Association between Leg Atherosclerosis and Clinical Indices

Hirofumi Matsuoka, Yusuke Matsumoto, Kengo Kimura, Midori Koyama, Towa Uzu, Yasuko Koma, Kensuke Fukumitsu, Yoshitaka Kasai, Nariyasu Nakashima, Daiki Masuya, Harukazu Yoshimatsu, Yujiro Suzuki

Department of Respiratory Medicine, Shinko Hospital, Kobe, Japan.

DOI: 10.4236/ojrd.2013.31005                

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.

Keywords

COPD; Peripheral Artery Disease; Leg Atherosclerosis; Ankle-Brachial Index

Conflicts of Interest

The authors declare no conflicts of interest.

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