Bhatt SP, et al. - Analyzing data from the Subpopulations and intermediate outcome measures in chronic obstructive pulmonary disease [COPD] study (SPIROMICS), researchers ascertained if markers of systemic inflammation mediated a link between spirometric and radiographic features of COPD and coronary artery calcification (CAC). The study sample consisted of 300 participants, 75 each of lifetime non-smokers, smokers without airflow obstruction, mild-moderate COPD, and severe-very severe COPD. After adjustment for demographics, diabetes mellitus, hypertension, statin use, and CT scanner type, forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) but not quantitative emphysema or airway wall thickening was linked to CAC. The correlation between airflow obstruction and coronary calcification is primarily driven by the centrilobular subtype of emphysema and is linked by bioactive molecules involved in atherosclerosis pathogenesis.