Identification and prospective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes
| Autor: | Judith, Garcia-Aymerich, Federico P, Gómez, Marta, Benet, Eva, Farrero, Xavier, Basagaña, Àngel, Gayete, Carles, Paré, Xavier, Freixa, Jaume, Ferrer, Antoni, Ferrer, Josep, Roca, Juan B, Gáldiz, Jaume, Sauleda, Eduard, Monsó, Joaquim, Gea, Joan A, Barberà, Àlvar, Agustí, Josep M, Antó, José, Belda |
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| Přispěvatelé: | Universitat de Barcelona |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Thorax medicine.medical_specialty Respiratory diseases Clinical trials Malalties pulmonars obstructives cròniques Partial Pressure Disease Systemic inflammation Malalties de l'aparell respiratori Pulmonary Disease Chronic Obstructive Quality of life Forced Expiratory Volume Internal medicine Diabetes mellitus medicine Assaigs clínics Humans Chronic obstructive pulmonary diseases Life Style Aged COPD business.industry Respiratory disease Respiratory organs diseases Middle Aged Prognosis medicine.disease respiratory tract diseases Hospitalization Oxygen Social Class Spain Physical therapy Sputum Female medicine.symptom Epidemiologic Methods business |
| Zdroj: | Recercat. Dipósit de la Recerca de Catalunya instname Dipòsit Digital de la UB Universidad de Barcelona |
| Popis: | Background Chronic obstructive pulmonary disease (COPD) is increasingly considered a heterogeneous condition. It was hypothesised that COPD, as currently defined, includes different clinically relevant subtypes. Methods To identify and validate COPD subtypes, 342 subjects hospitalised for the first time because of a COPD exacerbation were recruited. Three months after discharge, when clinically stable, symptoms and quality of life, lung function, exercise capacity, nutritional status, biomarkers of systemic and bronchial inflammation, sputum microbiology, CT of the thorax and echocardiography were assessed. COPD groups were identified by partitioning cluster analysis and validated prospectively against cause-specific hospitalisations and all-cause mortality during a 4 year follow-up. Results Three COPD groups were identified: group 1 (n ¼ 126, 67 years) was characterised by severe airflow limitation (postbronchodilator forced expiratory volume in 1 s (FEV 1 ) 38% predicted) and worse performance in most of the respiratory domains of the disease; group 2 (n ¼ 125, 69 years) showed milder airflow limitation (FEV 1 63% predicted); and group 3 (n ¼ 91, 67 years) combined a similarly milder airflow limitation (FEV 1 58% predicted) with a high proportion of obesity, cardiovascular disorders, iabetes and systemic inflammation. During follow-up, group 1 had more frequent hospitalisations due to COPD (HR 3.28, p < 0.001) and higher all-cause mortality (HR 2.36, p ¼ 0.018) than the other two groups, whereas group 3 had more admissions due to cardiovascular disease (HR 2.87, p ¼ 0.014). Conclusions In patients with COPD recruited at their first hospitalisation, three different COPD subtypes were identified and prospectively validated:"severe respiratory COPD","moderate respiratory COPD", and"systemic COPD' |
| Databáze: | OpenAIRE |
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