PT - JOURNAL ARTICLE AU - B Waschki AU - AM Kirsten AU - O Holz AU - T Meyer AU - R Lichtinghagen AU - KF Rabe AU - H Magnussen AU - T Welte AU - H Watz AU - S Janciauskiene TI - Angiopoietin-like protein 4 and cardiovascular function in COPD AID - 10.1136/bmjresp-2016-000161 DP - 2016 Oct 01 TA - BMJ Open Respiratory Research PG - e000161 VI - 3 IP - 1 4099 - http://bmjopenrespres.bmj.com/content/3/1/e000161.short 4100 - http://bmjopenrespres.bmj.com/content/3/1/e000161.full SO - BMJ Open Resp Res2016 Oct 01; 3 AB - Introduction 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.