New research from the Netherlands shows that older patients with chronic obstructive pulmonary disease (COPD) are at increased risk for carotid artery plaque formation and for the presence of vulnerable plaques with a lipid core, according to the American Thoracic Society. 

The cross-sectional study, part of the Rotterdam Study, an ongoing population-based cohort study examining the occurrence of and risk factors for chronic diseases in subjects aged 55 years and older, involved 253 patients with COPD and 920 patients without the condition. COPD was confirmed by spirometry. Participations with carotid wall thickening (intima-media thickness ≥ 2.5 mm) on ultrasonography underwent high-resolution MRI to characterize carotid plaques.

Participants with COPD had a twofold increased risk of carotid wall thickening on ultrasonography compared with controls. This risk increased significantly with the severity of airflow limitation. On MRI, vulnerable lipid core plaques were significantly more frequent in participants with COPD compared with those without COPD.

"Clinicians should be aware that COPD patients are at increased risk for asymptomatic carotid atherosclerosis and that COPD might lead to vulnerable plaques by inducing or aggravating the presence of plaques with a lipid core," said researcher Bruno H.C. Stricker, MD, PhD.

 "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 this devastating complication," he added.

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.