{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:12:30Z","timestamp":1784265150506,"version":"3.55.0"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T00:00:00Z","timestamp":1651017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>COPD and coronary heart disease (CHD) frequently co-occur, yet which COPD phenotypes are most prone to CHD is poorly understood. The aim of this study was to see whether COPD patients did have a true higher risk for CHD than subjects without COPD, and to examine a range of potential factors associated with CHD in COPD patients and controls.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>347 COPD patients and 428 non-COPD controls, were invited for coronary computed tomography angiography (CCTA) and pulmonary CT. Arterial blood gas, bioelectrical impedance and lung function was measured, and a detailed medical history taken. The CCTA was evaluated for significant coronary stenosis and calcium score (CaSc), and emphysema defined as &gt;10% of total area &lt;-950 Hounsfield units.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>12.6% of the COPD patients and 5.7% of the controls had coronary stenosis (p&lt;0.01), whereas 55.9% of the COPD patients had a CaSc&gt;100 compared to 31.6% of the controls (p&lt;0.01). In a multivariable model adjusting for sex, age, body composition, pack-years, CRP, cholesterol\/blood pressure lowering medication use and diabetes mellitus, the OR (95% CI) for having significant stenosis was 1.80 (0.86\u20133.78) in COPD patients compared with controls. In a similar model, the OR (95% CI) for having CaSc&gt;100 was 1.68 (1.12\u20132.53) in COPD patients compared with controls. Examining the risk of significant stenosis and CaSc&gt;100 among COPD patients, no variable was associated with significant stenosis, whereas male sex [OR 2.85 (1.56\u20135.21)], age [OR 3.74 (2.42\u20135.77)], statin use [OR 2.23 (1.23\u20134.50)] were associated with CaSc&gt;100, after adjusting for body composition, pack-years, C-reactive protein, use of angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), diabetes, emphysema score, GOLD category, exacerbation frequency, eosinophilia, and hypoxemia.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>COPD patients were more likely to have CHD, but neither emphysema score, lung function, exacerbation frequency, nor hypoxemia predicted presence of either coronary stenosis or CaSc&gt;100.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0265682","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T17:22:08Z","timestamp":1651080128000},"page":"e0265682","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["Factors associated with coronary heart disease in COPD patients and controls"],"prefix":"10.1371","volume":"17","author":[{"given":"Christina D.","family":"Svendsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel K. J.","family":"Kuiper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristoffer","family":"Ostridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terje H.","family":"Larsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2799-0430","authenticated-orcid":true,"given":"Rune","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidar","family":"Hodneland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Nordeide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per S.","family":"Bakke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8725-9960","authenticated-orcid":true,"given":"Tomas M.","family":"Eagan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,4,27]]},"reference":[{"issue":"8","key":"pone.0265682.ref001","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/S2213-2600(15)00241-6","article-title":"Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis","volume":"3","author":"W Chen","year":"2015","journal-title":"Lancet Respir Med"},{"key":"pone.0265682.ref002","volume-title":"Global Health Estimates 2016: Disease burden by Cause, Age, Sex, By Country and by Region, 2000\u20132016","author":"WHO","year":"2018"},{"issue":"4","key":"pone.0265682.ref003","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.trsl.2013.05.001","article-title":"Chronic obstructive pulmonary disease and cardiovascular disease","volume":"162","author":"SP Bhatt","year":"2013","journal-title":"Transl Res"},{"issue":"11","key":"pone.0265682.ref004","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1136\/thx.2009.128082","article-title":"Prevalence of major comorbidities in subjects with COPD and incidence of myocardial infarction and stroke: a comprehensive analysis using data from primary care","volume":"65","author":"JR Feary","year":"2010","journal-title":"Thorax"},{"issue":"1","key":"pone.0265682.ref005","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3109\/15412550903499506","article-title":"Cardiovascular morbidity in COPD: A study of the general population","volume":"7","author":"P Lange","year":"2010","journal-title":"COPD"},{"issue":"12","key":"pone.0265682.ref006","doi-asserted-by":"crossref","first-page":"1228 e13","DOI":"10.1016\/j.amjmed.2012.05.018","article-title":"Coronary artery disease is under-diagnosed and under-treated in advanced lung disease","volume":"125","author":"RM Reed","year":"2012","journal-title":"Am J Med"},{"issue":"6","key":"pone.0265682.ref007","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1183\/09031936.00133805","article-title":"Mortality in COPD: Role of comorbidities","volume":"28","author":"DD Sin","year":"2006","journal-title":"Eur Respir J"},{"issue":"4","key":"pone.0265682.ref008","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1378\/chest.128.4.2099","article-title":"Patterns of comorbidities in newly diagnosed COPD and asthma in primary care","volume":"128","author":"JB Soriano","year":"2005","journal-title":"Chest"},{"issue":"6","key":"pone.0265682.ref009","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1378\/chest.127.6.1952","article-title":"The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature","volume":"127","author":"DD Sin","year":"2005","journal-title":"Chest"},{"issue":"3","key":"pone.0265682.ref010","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1378\/chest.12-0938","article-title":"Cardiovascular disease in COPD: mechanisms","volume":"143","author":"JD Maclay","year":"2013","journal-title":"Chest"},{"issue":"12","key":"pone.0265682.ref011","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1093\/aje\/kwg276","article-title":"Lung function and incident coronary heart disease: the Atherosclerosis Risk in Communities Study","volume":"158","author":"EB Schroeder","year":"2003","journal-title":"Am J Epidemiol"},{"issue":"3","key":"pone.0265682.ref012","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1183\/09031936.00088209","article-title":"Systemic inflammatory markers in COPD: results from the Bergen COPD Cohort Study","volume":"35","author":"TM Eagan","year":"2010","journal-title":"Eur Respir J"},{"issue":"149","key":"pone.0265682.ref013","article-title":"Cardiovascular disease and COPD: dangerous liaisons?","volume":"27","author":"KF Rabe","year":"2018","journal-title":"Eur Respir Rev"},{"issue":"16","key":"pone.0265682.ref014","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1056\/NEJMra043430","article-title":"Inflammation, atherosclerosis, and coronary artery disease","volume":"352","author":"GK Hansson","year":"2005","journal-title":"N Engl J Med"},{"key":"pone.0265682.ref015","doi-asserted-by":"crossref","DOI":"10.3402\/ecrj.v1.26196","article-title":"The Bergen COPD microbiome study (MicroCOPD): rationale, design, and initial experiences","volume":"1","author":"R Gronseth","year":"2014","journal-title":"Eur Clin Respir J"},{"issue":"6","key":"pone.0265682.ref016","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1136\/thx.2009.122002","article-title":"Gender differences in COPD: are women more susceptible to smoking effects than men?","volume":"65","author":"IC Sorheim","year":"2010","journal-title":"Thorax"},{"issue":"2","key":"pone.0265682.ref017","first-page":"65","article-title":"Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2019 Report: Future Challenges","volume":"56","author":"JL Lopez-Campos","year":"2020","journal-title":"Arch Bronconeumol"},{"issue":"12","key":"pone.0265682.ref018","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1164\/rccm.200601-023OC","article-title":"Post-bronchodilator spirometry reference values in adults and implications for disease management","volume":"173","author":"A Johannessen","year":"2006","journal-title":"Am J Respir Crit Care Med"},{"issue":"7","key":"pone.0265682.ref019","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1038\/sj.ijo.0802037","article-title":"Fat-free mass index and fat mass index percentiles in Caucasians aged 18\u201398 y","volume":"26","author":"Y Schutz","year":"2002","journal-title":"Int J Obes Relat Metab Disord"},{"issue":"4","key":"pone.0265682.ref020","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/0735-1097(90)90282-T","article-title":"Quantification of coronary artery calcium using ultrafast computed tomography","volume":"15","author":"AS Agatston","year":"1990","journal-title":"J Am Coll Cardiol"},{"key":"pone.0265682.ref021","doi-asserted-by":"crossref","first-page":"579","DOI":"10.2147\/VHRM.S7457","article-title":"Using noncontrast cardiac CT and coronary artery calcification measurements for cardiovascular risk assessment and management in asymptomatic adults","volume":"6","author":"JA Rumberger","year":"2010","journal-title":"Vasc Health Risk Manag"},{"issue":"4","key":"pone.0265682.ref022","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1161\/hc0402.102975","article-title":"Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association","volume":"105","author":"MD Cerqueira","year":"2002","journal-title":"Circulation"},{"issue":"9","key":"pone.0265682.ref023","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/j.mri.2012.05.001","article-title":"3D Slicer as an image computing platform for the Quantitative Imaging Network","volume":"30","author":"A Fedorov","year":"2012","journal-title":"Magn Reson Imaging"},{"issue":"2","key":"pone.0265682.ref024","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1164\/ajrccm.152.2.7633722","article-title":"Comparison of computed density and macroscopic morphometry in pulmonary emphysema","volume":"152","author":"PA Gevenois","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"pone.0265682.ref025","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/s00330-012-2683-z","article-title":"Optimal threshold in CT quantification of emphysema","volume":"23","author":"Z Wang","year":"2013","journal-title":"Eur Radiol"},{"key":"pone.0265682.ref026","volume-title":"2015. Stata Statistical Software: Release 14","author":"2015 S. StataCorp","year":"2015"},{"key":"pone.0265682.ref027","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.rmed.2018.02.018","article-title":"Spirometric impairments, cardiovascular outcomes, and noncardiovascular death in older persons","volume":"137","author":"CA Vaz Fragoso","year":"2018","journal-title":"Respir Med"},{"key":"pone.0265682.ref028","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.2147\/COPD.S162713","article-title":"Coronary lesions in patients with COPD (Global Initiative for Obstructive Lung Disease stages I-III) and suspected or confirmed coronary arterial disease","volume":"13","author":"IL Mota","year":"2018","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"1","key":"pone.0265682.ref029","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1080\/15412555.2019.1566894","article-title":"The Association between Chronic Obstructive Pulmonary Disease and Coronary Artery Disease in Patients Undergoing Coronary Angiography","volume":"16","author":"Y Hong","year":"2019","journal-title":"COPD"},{"issue":"8","key":"pone.0265682.ref030","doi-asserted-by":"crossref","first-page":"2157","DOI":"10.1161\/01.CIR.92.8.2157","article-title":"Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study","volume":"92","author":"JA Rumberger","year":"1995","journal-title":"Circulation"},{"issue":"9","key":"pone.0265682.ref031","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1016\/j.rmed.2010.02.024","article-title":"Lung function, coronary artery calcification, and metabolic syndrome in 4905 Korean males","volume":"104","author":"HY Park","year":"2010","journal-title":"Respir Med"},{"issue":"4","key":"pone.0265682.ref032","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1183\/09031936.00165410","article-title":"Subclinical atherosclerosis, airflow obstruction and emphysema: the MESA Lung Study","volume":"39","author":"RG Barr","year":"2012","journal-title":"Eur Respir J"},{"issue":"2","key":"pone.0265682.ref033","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1148\/radiol.11110364","article-title":"Relationship and prognostic value of modified coronary artery calcium score, FEV1, and emphysema in lung cancer screening population: the MILD trial","volume":"262","author":"N Sverzellati","year":"2012","journal-title":"Radiology"},{"issue":"5","key":"pone.0265682.ref034","doi-asserted-by":"crossref","first-page":"e0126613","DOI":"10.1371\/journal.pone.0126613","article-title":"Coronary artery calcification, epicardial fat burden, and cardiovascular events in chronic obstructive pulmonary disease","volume":"10","author":"T Gaisl","year":"2015","journal-title":"PLoS One"},{"issue":"8","key":"pone.0265682.ref035","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1136\/thoraxjnl-2012-203151","article-title":"Coronary artery calcification is increased in patients with COPD and associated with increased morbidity and mortality","volume":"69","author":"MC Williams","year":"2014","journal-title":"Thorax"},{"key":"pone.0265682.ref036","doi-asserted-by":"crossref","first-page":"3321","DOI":"10.2147\/COPD.S172695","article-title":"Validation of lung density indices by cardiac CT for quantification of lung emphysema","volume":"13","author":"A Ronit","year":"2018","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"1","key":"pone.0265682.ref037","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.atherosclerosis.2009.08.037","article-title":"Associations of inflammatory markers with coronary artery calcification: results from the Multi-Ethnic Study of Atherosclerosis","volume":"209","author":"NS Jenny","year":"2010","journal-title":"Atherosclerosis"},{"issue":"2","key":"pone.0265682.ref038","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.atherosclerosis.2010.06.017","article-title":"Association of C-reactive protein and homocysteine with subclinical coronary plaque subtype and stenosis using low-dose MDCT coronary angiography","volume":"212","author":"T Lin","year":"2010","journal-title":"Atherosclerosis"},{"key":"pone.0265682.ref039","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.ijcard.2015.02.072","article-title":"High dose and long-term statin therapy accelerate coronary artery calcification","volume":"184","author":"M Henein","year":"2015","journal-title":"Int J Cardiol"},{"issue":"9","key":"pone.0265682.ref040","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1093\/ehjci\/jes060","article-title":"Meaning of zero coronary calcium score in symptomatic patients referred for coronary computed tomographic angiography","volume":"13","author":"YJ Kim","year":"2012","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"Suppl 1","key":"pone.0265682.ref041","first-page":"29","article-title":"Asymptomatic subjects with zero coronary calcium score: coronary CT angiographic features of plaques in event-prone patients","volume":"29","author":"MS Lee","year":"2013","journal-title":"Int J Cardiovasc Imaging"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0265682","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T19:06:57Z","timestamp":1700507217000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0265682"}},"subtitle":[],"editor":[{"given":"Kjell","family":"Tor\u00e9n","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,27]]},"references-count":41,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0265682","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,27]]}}}