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Centrilobular emphysema and coronary artery calcification: mediation analysis in the SPIROMICS cohort

Bhatt, Surya P ; Nath, Hrudaya P ; Kim, Young-Il ; Ramachandran, Rekha ; Watts, Jubal R ; Terry, Nina L J ; Sonavane, Sushil ; Deshmane, Swati P ; Woodruff, Prescott G ; Oelsner, Elizabeth C ; Bodduluri, Sandeep ; Han, MeiLan K ; Labaki, Wassim W ; Michael Wells, J ; Martinez, Fernando J ; Barr, R Graham ; Dransfield, Mark T

Respiratory research, 2018-12, Vol.19 (1), p.257-257, Article 257 [Periódico revisado por pares]

England: BioMed Central Ltd

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Título:
Centrilobular emphysema and coronary artery calcification: mediation analysis in the SPIROMICS cohort
Autor: Bhatt, Surya P ; Nath, Hrudaya P ; Kim, Young-Il ; Ramachandran, Rekha ; Watts, Jubal R ; Terry, Nina L J ; Sonavane, Sushil ; Deshmane, Swati P ; Woodruff, Prescott G ; Oelsner, Elizabeth C ; Bodduluri, Sandeep ; Han, MeiLan K ; Labaki, Wassim W ; Michael Wells, J ; Martinez, Fernando J ; Barr, R Graham ; Dransfield, Mark T
Assuntos: Aged ; Air flow ; Arteriosclerosis ; Atherosclerosis ; Biomarkers ; Biomarkers - blood ; Calcification ; Calcification (ectopic) ; Cardiovascular disease ; Cardiovascular diseases ; Chronic obstructive pulmonary disease ; Cohort Studies ; Computed tomography ; COPD ; Coronary arteries ; Coronary artery ; Coronary artery calcification ; Coronary artery disease ; Coronary Artery Disease - blood ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Demographics ; Demography ; Diabetes mellitus ; Discordance ; Emphysema ; Female ; Health risk assessment ; Health risks ; Heart diseases ; Humans ; Hypertension ; Inflammation Mediators - blood ; Lung diseases ; Male ; Mediators ; Middle Aged ; Obstructive lung disease ; Outcome Assessment, Health Care - methods ; Pathogenesis ; Pulmonary Disease, Chronic Obstructive - blood ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary Emphysema - blood ; Pulmonary Emphysema - diagnosis ; Pulmonary Emphysema - physiopathology ; Respiratory tract diseases ; Risk analysis ; Risk factors ; Risk sharing ; Smoking - blood ; Smoking - physiopathology ; Studies ; Thickening ; Tomography ; Vascular Calcification - blood ; Vascular Calcification - diagnosis ; Vascular Calcification - physiopathology ; Vital Capacity - physiology
É parte de: Respiratory research, 2018-12, Vol.19 (1), p.257-257, Article 257
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SourceType-Scholarly Journals-1
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Descrição: Chronic obstructive pulmonary disease (COPD) is associated with a two-to-five fold increase in the risk of coronary artery disease independent of shared risk factors. This association is hypothesized to be mediated by systemic inflammation but this link has not been established. We included 300 participants enrolled in the SPIROMICS cohort, 75 each of lifetime non-smokers, smokers without airflow obstruction, mild-moderate COPD, and severe-very severe COPD. We quantified emphysema and airway disease on computed tomography, characterized visual emphysema subtypes (centrilobular and paraseptal) and airway disease, and used the Weston visual score to quantify coronary artery calcification (CAC). We used the Sobel test to determine whether markers of systemic inflammation mediated a link between spirometric and radiographic features of COPD and CAC. FEV /FVC but not quantitative emphysema or airway wall thickening was associated with CAC (p = 0.036), after adjustment for demographics, diabetes mellitus, hypertension, statin use, and CT scanner type. To explain this discordance, we examined visual subtypes of emphysema and airway disease, and found that centrilobular emphysema but not paraseptal emphysema or bronchial thickening was independently associated with CAC (p = 0.019). MMP3, VCAM1, CXCL5 and CXCL9 mediated 8, 8, 7 and 16% of the association between FEV /FVC and CAC, respectively. Similar biomarkers partially mediated the association between centrilobular emphysema and CAC. The association between airflow obstruction and coronary calcification is driven primarily by the centrilobular subtype of emphysema, and is linked through bioactive molecules implicated in the pathogenesis of atherosclerosis. ClinicalTrials.gov: Identifier: NCT01969344 .
Editor: England: BioMed Central Ltd
Idioma: Inglês

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Centrilobular emphysema and coronary artery calcification: mediation analysis in the SPIROMICS cohort

England: BioMed Central Ltd

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