LAUSR

BACKGROUND The observation that chronic obstructive pulmonary disease (COPD) is an independent risk factor for cardiovascular disease (CVD) comes from comparisons between smokers with COPD and smokers without COPD. The mechanisms that explain increased risk of CVD in patients with COPD are still unclear. OBJECTIVES To assess systemic arterial stiffness (a predictor of CVD mortality) and to evaluate its determinants in a group of patients with mild-to-moderate COPD secondary to organic dust exposure, tobacco smoking or both. METHODS Systemic arterial stiffness was assessed by aortic pulse wave velocity (aPWV). Measurements were made in 142 COPD patients and 155 healthy controls matched for age, sex, body mass index and tobacco smoking, exposed to tobacco smoking (n=56/70 for COPD/controls, respectively), organic dusts (n=44/48), or both (n=42/37). MAIN RESULTS aPWV was higher in COPD than in healthy controls in subjects exposed to tobacco smoking and to both dusts and tobacco smoking. By contrast, among never-smokers exposed to organic dusts, COPD patients and matched controls had similar aPWV. Multivariate analysis of the 142 COPD patients (exposed to tobacco smoking and/or to organic dusts) demonstrated that tobacco smoking was associated with high aPWV. Moreover, soluble suppression of tumorigenicity 2 (ST2), a marker of major cardiovascular events, was correlated with aPWV in these patients. CONCLUSIONS Analysis of an unselected group of COPD patients with different causes suggests that 1) COPD by itself is not sufficient to explain increased aPWV, and 2) tobacco smoking is a risk factor for elevated aPWV in COPD.