CC BY-NC 4.0Waschki, BenjaminBenjaminWaschkiKirsten, Anne-MarieAnne-MarieKirstenHolz, OlafOlafHolzMeyer, T.T.MeyerLichtinghagen, R.R.LichtinghagenRabe, K.F.K.F.RabeMagnussen, HelgoHelgoMagnussenWelte, T.T.WelteWatz, H.H.WatzJanciauskiene, S.S.Janciauskiene2022-03-056.5.20172016https://publica.fraunhofer.de/handle/publica/24828710.24406/publica-r-24828710.1136/bmjresp-2016-000161INTRODUCTION: The coexistence of chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) is frequent and might be inter-related through inflammation-related processes reflected by specific markers. Here, we studied angiopoietin-like protein 4 (ANGPTL4), an upcoming cardiovascular marker, in stable COPD, and its relationship to cardiovascular function with respect to well-known CVD risk factors. METHODS: In a prospective COPD cohort study, we investigated serum ANGPTL4 levels, vascular status (ankle-brachial index (ABI)) and cardiac function (N-terminal pro-B-type natriuretic peptide (NT-proBNP)) as well as airflow limitation, objectively measured physical activity, the metabolic syndrome, high-sensitive C reactive protein (hs-CRP) and other CVD risk factors at 2 time points. We initially studied 74 stable COPD patients and 18 controls. For internal validation, we additionally studied 160 COPD patients of a former visit. RESULTS: ANGPTL4 was significantly elevated in COPD patients compared with controls (p=0.026). After correction for traditional CVD risk factors, including hs-CRP, higher levels of ANGPTL4 were independently associated with lower ABI (p=0.023) and higher NT-proBNP (p<0.001). These findings were confirmed in the internal validation analysis, which included echocardiographic assessments. CONCLUSIONS: Serum ANGPTL4 is independently associated with cardiovascular function in COPD and might qualify as a biomarker reflecting a pathogenic link between COPD and CVD.enCOPD AU mechanismssystemic disease and lungs610620journal article