Introduction COPD is a risk factor for cardiovascular comorbidities. Elastin degradation represents a shared mechanism for the pulmonary and vascular features. Methods and Results Plasma desmosine (pDES), a marker of elastin degradation, was measured in 955 COPD patients (609 male, age 63.1 ± 7.2 years, FEV 1 50.6 ± 15.1%predicted) by an isotope dilution LC-MS/MS method. Coronary artery calcification (CACS), a surrogate of atherosclerosis, was assessed in 440 standard CT scan images (low 1000 AU). Results pDES was elevated in patients with cardiovascular comorbidities (p 1 (r = 0.39, p Figure 1 ) and in patients that died during a 3 year follow-up (p Conclusion pDES relates to lung function, systemic inflammation, cardiovascular comorbidities, and CACS in patients with COPD. pDES is a predictor of all cause overall mortality. The ECLIPSE study (GSK Study No. SCO104960, NCT00292552) was sponsored by GlaxoSmithKline.