Povezanost kronične opstruktivne plućne bolesti s povišenim kardiovaskularnim rizikom [The association of chronic obstructive pulmonary disease and elevated cardiovascular risk]

Ljubičić, Đivo (2018) Povezanost kronične opstruktivne plućne bolesti s povišenim kardiovaskularnim rizikom [The association of chronic obstructive pulmonary disease and elevated cardiovascular risk]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

The aim of the study of this doctoral dissertation was to compare cardiovascular (CV) risk in patients with COPD to control groups of smokers and non-smokers without COPD and to investigate the relation of lung function variables, COPD severity and smoking with SCORE risk calculation, arterial stiffness values and biological systemic inflammatory markers (hs-CRP and fibrinogen). In this cross-sectional study, a total of 208 subjects participated. The results of the study confirm increased elevated CV risk in subjects with COPD compared to control groups. Subjects with COPD had higher SCORE values, higher central aortic pressure, arterial stiffness and inflammatory markers. The association of smoking status to SCORE values and to the levels of hs-CRP and fibrinogen levels was demonstrated in post hoc analysis. Arterial stiffness is significantly increased in the COPD subjects. There was positive correlation of lung function variables with investigated variables of elevated CV risk. There is also association between SCORE variables, arterial stiffness and inflammatory markers. There was no significant difference in CV risk with respect to COPD phenotype. Considering the GOLD assessment of COPD, there is a positive correlation with SCORE values and arterial stiffness. The results of the study support the need for further identification and research of biological markers and specific tests, such as arteriography, which would enable better understanding of the complexity and heterogeneity of COPD, which would lead to progress towards personalized treatment of these patients, better primary or secondary prevention of comorbidities, improved treatment outcomes and ultimately, survival.

Abstract in Croatian

Cilj istraživanja ove doktorske disertacije bio je utvrditi povišeni kardiovaskularni (KV) rizik kod bolesnika s KOPB-om u odnosu na kontrolne skupine pušača i nepušača bez KOPB-a, te istražiti povezanost varijabli plućne funkcije, stupanj težine KOPB-a i pušenja s rezultatima SCORE izračuna rizika, vrijednostima arterijske krutosti (AS) i bioloških biljega sustavne upale (hs-CRP i fibrinogen). U presječnom istraživanju sudjelovalo je ukupno 208 ispitanika. Rezultati istraživanja potvrdili su povišeni KV rizik kod ispitanika s KOPB-om u odnosu na kontrolne skupine. Ispitanici s KOPB-om imaju više vrijednosti SCORE-a, viši centralni aortalni tlak i AS te biljege sustavne upale. U post hoc analizi pokazana je povezanost pušačkog staža s vrijednostima SCORE izračuna i razinama hs-CRP-a te fibrinogena. Kod skupine s KOPB-om značajno je povišena AS. Utvrđena je pozitivna korelacija varijabli plućne funkcije s istraživanim varijablama povišenog KV rizika. Povezanost je prisutna između varijabli SCORE-a i AS te biljega upale. Nije utvrđena značajna razlika u KV riziku s obzirom na fenotip KOPB-a. S obzirom na GOLD procjenu KOPB-a, postoji pozitivna korelacija s vrijednostima SCORE-a i AS. Rezultati istraživanja podupiru daljnju identifikaciju te istraživanje bioloških biljega i specifičnih testova, poput arteriografije, koji bi omogućili bolje razumijevanje kompleksnosti i heterogenosti KOPB-a te bi mogli dovesti do napretka u personaliziranom liječenju ovih bolesnika, bolje primarne ili sekundarne prevencije komorbiditeta, poboljšanih ishoda liječenja te preživljenja.

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