GOLD stage predicts thoracic aortic calcifications in patients with COPD

Jobst,Bertram  J.; Owsijewitsch,Michael; Kauczor,Hans‑Ulrich; Biederer,Jürgen; Ley,Sebastian; Becker,Nikolaus; Kopp‑Schneider,Annette; Delorme,Stefan; Heussel,Claus  Peter; Puderbach,Michael; Wielpütz,Mark  O.; Ley‑Zaporozhan,Julia

doi:10.3892/etm.2018.7039

GOLD stage predicts thoracic aortic calcifications in patients with COPD

Authors:
- Bertram J. Jobst
- Michael Owsijewitsch
- Hans‑Ulrich Kauczor
- Jürgen Biederer
- Sebastian Ley
- Nikolaus Becker
- Annette Kopp‑Schneider
- Stefan Delorme
- Claus Peter Heussel
- Michael Puderbach
- Mark O. Wielpütz
- Julia Ley‑Zaporozhan
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Affiliations: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, D‑69120 Heidelberg, Germany, Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ Heidelberg), D‑69120 Heidelberg, Germany, Division of Biostatistics, German Cancer Research Centre (DKFZ Heidelberg), Germany, Department of Radiology, German Cancer Research Centre (DKFZ Heidelberg), D‑69120 Heidelberg, Germany, Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University of Heidelberg, D‑69126 Heidelberg, Germany
Published online on: November 30, 2018 https://doi.org/10.3892/etm.2018.7039
Pages: 967-973

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Abstract

Although some of the associations between chronic obstructive pulmonary disease (COPD) and atherosclerosis are based on shared risk factors such as smoking, recent epidemiological evidence suggests that COPD is a risk factor for vascular disease due to systemic inflammation. The present study assessed the hypothesis that disease severity (as expressed by the GOLD stage) independently predicts the extent of vascular calcifications. A total of 160 smokers diagnosed with COPD (GOLD I‑IV, 40 subjects of each GOLD stage) and 40 smokers at risk (GOLD 0; median age of 60 years old; Q1:56;Q3:65; 135 males and 65 females) underwent non‑contrast, non‑electrocardiography synchronized chest computerised tomography. The volume of thoracic aortic calcifications was quantified semi‑automatically within a region from T1 through T12. Multiparametric associations with GOLD stage, smoking history, sex, age, body mass index and emphysema index were evaluated using generalized linear regression analysis. Thoracic aortic calcifications were highly prevalent in this cohort (187/200 subjects, 709 (Q1:109;Q3:2163) mm3). Analysis of variance on ranks demonstrated a significant difference in calcium between different GOLD‑stages as well as patients at risk of COPD (F=36.8, P<0.001). In the multivariable analysis, GOLD‑stages were indicated to be predictive of thoracic aortic calcifications (P≤0.0033) besides age (P<0.0001), while age appeared to be the strongest predictor. Other variables were not statistically linked to thoracic aortic calcifications in the multivariable model. COPD severity, as expressed by the GOLD‑stage, is a significant predictor of thoracic aortic calcifications, independent of covariates such as age or tobacco consumption.

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