MRI gives clearer picture of COPD stroke risk

Chronic obstructive pulmonary disease (COPD) patients are at increased risk for carotid artery thickening, show the results of a study in elderly men.

Magnetic resonance imaging (MRI) also revealed that COPD was an independent predictor of carotid plaques with a lipid core, which are associated with an increased risk for cerebrovascular events.

"Clinicians should be aware that asymptomatic carotid atherosclerosis is more prevalent in subjects with COPD and COPD as a systemic inflammatory disease might lead to vulnerable plaques by inducing or aggravating the presence of a lipid core," say Bruno Stricker (Erasmus Medical Center, Rotterdam, the Netherlands) and colleagues.

The study included 358 participants of the Rotterdam study, 88 of whom had COPD and 270 normal lung function. The median age of the participants was 78 years.

The authors found that on ultrasound, 74.7% of participants with COPD had carotid artery intima media thickening (≥ 2.5 mm), a significantly higher rate than the 54.9% observed among those with normal lung function.

When adjusted for confounding factors, patients with COPD had a 2.1-fold increase in the odds of lipid-core carotid plaques on MRI compared with those with no COPD. This risk was particularly pronounced in patients with dyspnea. For instance, COPD patients with a dyspnea score of 2 or more had a 2.7-fold increased odds for lipid-core plaques, compared with their non-COPD peers.

While it is known that COPD is a risk factor for ischemic stroke and that impaired lung function is linked to the formation of carotid plaques on ultrasonography, the plaque composition of patients with COPD has not previously been investigated.

Lead author Stricker said in a press release that his team's findings help to shed light on this relationship: "Understanding the underlying risk factors for stroke in COPD patients can help identify those at high risk and lead to the development of more personalized preventive treatment strategies targeting the devastating complication."

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