COPD Heterogeneity and Progression: Emphysema-Predominant and Non-Emphysema-Predominant Disease

Autor: Peter J Castaldi, Zhonghui Xu, Kendra A Young, John E Hokanson, David A Lynch, Stephen M Humphries, James C Ross, Michael H Cho, Craig P Hersh, James D Crapo, Matthew Strand, Edwin K Silverman
Rok vydání: 2023
Předmět:
Zdroj: American Journal of Epidemiology.
ISSN: 1476-6256
0002-9262
DOI: 10.1093/aje/kwad114
Popis: While variation in emphysema between COPD patients is well-recognized, clinically applicable definitions of emphysema-predominant (EPD) and non-emphysema-predominant (NEPD) subtypes have not been established. To study the clinical relevance of EPD and NEPD subtypes, we tested the association of these subtypes to prospective FEV1 decline and mortality in 3,427 subjects with GOLD spirometric grade 2-4 COPD at baseline in the COPDGene Study, an ongoing national multicenter study that started in 2007. NEPD was defined as airflow obstruction with =10% CT emphysema. Mixed effects models for FEV1 demonstrated larger average annual FEV1 loss in EPD versus NEPD subjects (-10.2 ml/yr, p 0.9. NEPD and EPD COPD subtypes capture important aspects of COPD heterogeneity and are associated with different rates of disease progression and mortality.
Databáze: OpenAIRE
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