Peripheral Artery Disease and Its Clinical Relevance in Patients with Chronic Obstructive Pulmonary Disease in the COPD and Systemic Consequences-Comorbidities Network Study.

Abstract

RATIONALE:

Knowledge about the prevalence of objectively assessed peripheral artery disease (PAD) and its clinical relevance in patients with chronic obstructive pulmonary disease (COPD) is scarce.

OBJECTIVES:

We aimed to: (1) assess the prevalence of PAD in COPD compared with distinct control groups; and (2) study the association between PAD and functional capacity as well as health status.

METHODS:

The ankle-brachial index was used to diagnose PAD (ankle-brachial index ≤ 0.9). The 6-minute-walk distance, health status (St. George's Respiratory Questionnaire), COPD Assessment Test, and EuroQol-5-Dimensions were assessed in patients enrolled in the German COPD and Systemic Consequences-Comorbidities Network cohort study. Control groups were derived from the Study of Health in Pomerania.

MEASUREMENTS AND MAIN RESULTS:

A total of 2,088 patients with COPD (61.1% male; mean [SD] age, 65.3 [8.2] years, GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I-IV: 9.4, 42.5, 37.5, and 10.5%, respectively) were included, of which 184 patients (8.8%; GOLD stage I-IV: 5.1, 7.4, 11.1, and 9.5%, respectively, vs. 5.9% in patients with GOLD stage 0 in the COPD and Systemic Consequences-Comorbidities Network) had PAD. In the Study of Health in Pomerania, PAD ranged from 1.8 to 4.2%. Patients with COPD with PAD had a significantly shorter 6-minute-walk distance (356 [108] vs. 422 [103] m, P < 0.001) and worse health status (St. George's Respiratory Questionnaire: 49.7 [20.1] vs. 42.7 [20.0] points, P < 0.001; COPD Assessment Test: 19.6 [7.4] vs. 17.9 [7.4] points, P = 0.004; EuroQol-5-Dimensions visual analog scale: 51.2 [19.0] vs. 57.2 [19.6], P < 0.001). Differences remained significant after correction for several confounders.

CONCLUSIONS:

In a large cohort of patients with COPD, 8.8% were diagnosed with PAD, which is higher than the prevalence in control subjects without COPD. PAD was associated with a clinically relevant reduction in functional capacity and health status.

• Authors: Sarah Houben-Wilke, Rudolf A Jörres, Robert Bals, Frits M E Franssen, Sven Gläser, Rolf Holle, Annika Karch, Armin Koch, Helgo Magnussen, Anne Obst, Holger Schulz, Martijn A Spruit, Margarethe E Wacker, Tobias Welte, Emiel F M Wouters, Claus Vogelmeier, Henrik Watz
• Journal: American journal of respiratory and critical care medicine (Am J Respir Crit Care Med) Vol. 195 Issue 2 Pg. 189-197 (01 15 2017) ISSN: 1535-4970 [Electronic] United States
• PMID: 27532739 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)

Topics

• Activities of Daily Living
• Aged
• Ankle Brachial Index
• Comorbidity
• Female
• Health Status
• Humans
• Longitudinal Studies
• Male
• Peripheral Arterial Disease (complications, epidemiology)
• Prevalence
• Prospective Studies
• Pulmonary Disease, Chronic Obstructive (complications, epidemiology)