Clinical ACO phenotypes: Description of a heterogeneous entity
Autor: | Gilles Devouassoux, P. Vercherin, P. Beynel, L. Falchero, S. Lainez, T. Didi, I. Court-Fortune, D. Piperno, Jean-Michel Vergnon, M. Froudarakis, E. Frappe |
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Rok vydání: | 2019 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Exacerbation Case Report Late onset Disease 03 medical and health sciences 0302 clinical medicine Internal medicine medicine COPD Prospective cohort study Asthma lcsh:RC705-779 ACO business.industry MCA lcsh:Diseases of the respiratory system medicine.disease Comorbidity respiratory tract diseases Phenotype 030228 respiratory system Cluster 030220 oncology & carcinogenesis Heterogeneity business Body mass index |
Zdroj: | Respiratory Medicine Case Reports Respiratory Medicine Case Reports, Vol 28, Iss, Pp-(2019) |
ISSN: | 2213-0071 |
Popis: | Background: Because ACO (Asthma-COPD-Overlap) does not fill out asthma or COPD (Chronic Obstructive Pulmonary Disease) criteria, such patients are poorly evaluated. The aim of this study was to screen asthma and COPD for an alternative diagnosis of ACO, then to determine subgroups of patients, using cluster analysis. Material and methods: Using GINA-GOLD stepwise approach, asthmatics and COPD were screened for ACO. Clusterization was then performed employing Multiple Correspondent Analysis (MCA) model, encompassing 9 variables (age, symptoms onset, sex, BMI (Body Mass Index), smoking, FEV-1, dyspnea, exacerbation, comorbidity). Finally, clusters were compared to determine phenotypes. Results: MCA analysis was performed on 172 ACO subjects. To better distinguish clusters, the analysis was then focused on 55 subjects, having at least one cosine squared >0.3. Six clusters were identified, allowing the description of 4 phenotypes. Phenotype A represented overweighed heavy smokers, with an early onset and a severe disease (27% of ACO patients). Phenotype B gathered similar patients, with a late onset (29%). Patients from Phenotypes C-D were slighter smokers, presenting a moderate disease, with early and late onset respectively (respectively 13% and 31%). Conclusions: By providing evidences for clusters within ACO, our study confirms its heterogeneity, allowing the identification of 4 phenotypes. Further prospective studies are mandatory to confirm these data, to determine both specific management requirements and prognostic value. Keywords: ACO, Asthma, COPD, Cluster, Phenotype, Heterogeneity, MCA |
Databáze: | OpenAIRE |
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