Blood biomarkers as predictors of long‐term mortality in COPD

Mendy, Angelico; Forno, Erick; Niyonsenga, Théophile; Gasana, Janvier

doi:10.1111/crj.12752

Cited by 49 publications

(41 citation statements)

References 45 publications

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“…In the current study, CRP did not differ significantly between the seasons and was not correlated with serum 25(OH)D concentration at either time point, a finding that confirms the findings of others 52. Although higher concentrations of CRP have been associated with impaired lung function, the role of CRP in the etiology of COPD and respiratory function remains poorly understood 56,57. Further research is also warranted to elucidate the relationship between vitamin D and immune-respiratory function in COPD.…”

Section: Discussionsupporting

confidence: 86%

Vitamin D status is associated with muscle strength and quality of life in patients with COPD: a seasonal prospective observation study

Carson¹,

Pourshahidi²,

Madigan³

et al. 2018

COPD

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BackgroundOwing to hospitalization, reduced functional capacity and consequently, less sunlight exposure, suboptimal vitamin D status (25-hydroxyvitamin D [25(OH)D]⩽50 nmol/L) is prevalent among COPD patients.ObjectiveThis study aimed to investigate seasonal changes in vitamin D status and any associated changes in fat-free mass (FFM), muscle strength and quality of life (QoL) in COPD patients.Patients and methodsCOPD patients living in Northern Ireland (n=51) completed study visits at the end of winter (March/April) and at the end of summer (September/October), corresponding to the nadir and peak of vitamin D status, respectively. At both time points, serum concentration of 25(OH)D was quantified by liquid chromatography-tandem mass spectrometry, FFM (kg) was measured using bioelectrical impedance and muscle strength (kg) was measured using handgrip dynamometry. QoL was assessed using the validated St George’s Respiratory Questionnaire.ResultsMean±SD 25(OH)D concentration was significantly higher at the end of summer compared to the end of winter (52.5±30.5 nmol/L vs 33.7±28.4 nmol/L, P<0.001); and house- bound patients had significantly lower 25(OH)D concentration compared to nonhousebound patients at the end of summer (42.9±4.2 vs 57.2±9.9 nmol/L; P⩽0.001). Muscle strength (at both time points) and QoL (end of summer only) were positively predicted by 25(OH)D concentration, independent of age, sex and smoking status.ConclusionThis study highlights the need for health policies to include a recommendation for year-round vitamin D supplementation in housebound COPD patients, and wintertime supplementation in nonhousebound patients, to maintain optimal 25(OH)D concentrations to protect musculoskeletal health. Furthermore, an optimal vitamin D status may have potential benefits for QoL in these patients.

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Section: Discussionsupporting

confidence: 86%

Vitamin D status is associated with muscle strength and quality of life in patients with COPD: a seasonal prospective observation study

Carson¹,

Pourshahidi²,

Madigan³

et al. 2018

COPD

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“…Previous studies have shown that CRP could be used as an independent in uencing factor to evaluate the control level of COPD chronic in ammation in patients, [12][13][14] while ALB is a prognostic marker of infection-related disease. 15 Our study observed that high CRP and PCT levels as well as low ALB level were associated with death in AECOPD patients with HF.…”

Section: Discussionmentioning

confidence: 99%

Optimized Combination of Circulating Biomarkers as Predictors of Prognosis in AECOPD Patients Complicated with Heart Failure

Yao

Wang

Shi

et al. 2020

Preprint

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BackgroundSystematic inflammation, nutritional status, and cardiovascular function have been associated with the outcomes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with heart failure (HF). However, the value of their relevant biomarkers in predicting mortality has not been well defined yet. We aimed to investigate the prognostic value of circulating biomarkers including C-reaction protein (CRP) /albumin (ALB), neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and N-terminal pro-brain natriuretic peptide (NT-proBNP) for AECOPD patients with HF.Methods A total of 146 cases of AECOPD complicated with HF were enrolled and classified into survivor group (n=94) and non-survivor group (n=52). The baseline characteristics and blood-based biomarkers were collected. The predictors for prognosis were analyzed by multivariate logistic regression, and the ability to predict 28-day mortality was evaluated by receiver operating characteristics curve (ROC) and the area under the curve (AUC).ResultsThe patients in non-survivors had significantly higher levels of CRP, CRP/ALB, NLR, PCT and NT-proBNP, but lower ALB levels compared to the survivors [145.8±110.1 VS. 66.6±70.2mg/L, 5.9±4.9 VS. 2.3±2.6, 22.2 (11.1, 40.1) VS. 12.0 (6.2, 24.8), 2.6 (0.2, 10.3) VS. 0.08 (0.1, 0.5)ng/ml, 17912.5 (9344.0, 34344.5) VS. 9809.0 (4415.9, 16387.2)ng/ml, 26.8±6.4 VS. 31.0±4.6g/L; P < 0.001, <0.001, 0.001, <0.001, <0.001, and < 0.001, respectively]. No significant difference in PLR was found between the two groups (P=0.413). The logistic analysis revealed that CRP/ALB (OR=1.303, 95%CI: 1.145-1.483, P<0.001), NT-proBNP (OR=1.041, 95%CI: 1.010-1.073, P=0.009) and NLR (OR=1.010, 95%CI: 0.999-1.022, P<0.001) are independent risk factors for predicting the 28-day mortality. The AUC of the ROC curves were 0.768, 0.767, 0.757, 0.723, 0.716, and 0.668 for CRP/ALB, PCT, CRP, NT-proBNP, ALB, and NLR, respectively. The combination of CRP/ALB, NLR and NT-proBNP as biomarkers was shown to have better accuracy for predicting prognosis (AUC=0.830, 95%CI: 0.761-0.899, P<0.001), with a higher specificity of 80.8% and specificity of 77.7% as compared with each single biomarkers.ConclusionsHigh levels of NLR, CRP/ALB and NT-proBNP may be clinical usefully predictors for death in AECOPD patients with HF. Combination of NLR with CRP/ALB and NT-proBNP can provide a higher accuracy for predicting 28-day mortality in these patients.

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“…A meta-analysis in COPD patients showed that CRP elevation is especially significant in late mortality (11). High CRP and neutrophil levels, as well as low eosinophil levels have been shown to be poor prognostic factors (12).…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between C Reactive Protein /Albumin Ratio And 1-Year Mortality In Hospitalized Elderly Copd Patients With Acute Exacerbation

Tur¹

2019

tjgeri

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Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality. C-reactive protein (CRP) is often elevated with acute infective and inflammatory situations. Hypoalbuminemia may be linked to chronic diseases and malnutrition. Here, we investigated the relationship between 1-year mortality and CRP/albumin ratio (CAR) among hospitalized elderly patients with COPD acute exacerbation. Materials and method: The records of patients who were hospitalized with COPD diagnosis in the internal medicine and chest diseases clinics of Kafkas University Medical Faculty Hospital between January 2014 and May 2017 were retrospectively evaluated to determine whether selected patients had died within 1 year of hospitalization. The patients who died (Group 1) and those who were living (Group 2) were compared in terms of various parameters, especially CAR. Results: In Group 1, CRP levels were high and albumin levels were significantly lower; the CAR ratio in group 1 was 0.36 (0.29-0.64), which was significantly elevated, compared with that of Group 2 (0.09; 0.03-0.27). In the multivariate analysis, independent predictors of 1-year mortality were CAR [1.116 (1.025-1.216), p=0.011], smoking (packs/year) [1.135 (1.082-1.190), p<0.05], pH [0.001 (0-0.14)], BODE index [1.693 (1.157-2.478)], and FEV1/FVC [0.911 (0.846-0.980)]. Area under the curve values of CAR for 1-year mortality were significantly higher than the values of both albumin and CRP alone (p<0.05). Conclusion: The CRP/albumin ratio is an independent predictor of 1-year mortality in patients with COPD. More comprehensive prospective studies are needed to confirm this finding.

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Blood biomarkers as predictors of long‐term mortality in COPD

Abstract: High CRP and neutrophils as well as low eosinophils are predictive of poor COPD prognosis. They also add significant value to prediction models of mortality in COPD.

Cited by 49 publications

References 45 publications

Vitamin D status is associated with muscle strength and quality of life in patients with COPD: a seasonal prospective observation study

Vitamin D status is associated with muscle strength and quality of life in patients with COPD: a seasonal prospective observation study

Optimized Combination of Circulating Biomarkers as Predictors of Prognosis in AECOPD Patients Complicated with Heart Failure

The Relationship Between C Reactive Protein /Albumin Ratio And 1-Year Mortality In Hospitalized Elderly Copd Patients With Acute Exacerbation

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