Clusters of Comorbidities Based on Validated Objective Measurements and Systemic Inflammation in Patients with Chronic Obstructive Pulmonary Disease

Vanfleteren, Lowie E.G.W.; Spruit, Martijn A.; Groenen, Miriam T.J.; Gaffron, Swetlana; Empel, Vanessa van; Bruijnzeel, P. L. B.; Rutten, Erica P.A.; Roodt, Jos Op ‘t; Wouters, Emiel F.M.; Franssen, Frits M.E.

doi:10.1164/rccm.201209-1665oc

Cited by 693 publications

(664 citation statements)

References 48 publications

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“…Nevertheless, VANFLETEREN et al [2] have previously shown that these patients have similar characteristic compared to patients from other studies. Another possible limitation is that some analyses may be underpowered.…”

Section: Ckdsupporting

confidence: 49%

“…The "psychologic" cluster is characterised by more baseline symptoms of anxiety and depression [2]. Previously, VON LEUPOLDT et al [12] showed that more symptoms of anxiety and depression are associated with reduced exercise capacity.…”

Section: Ckdmentioning

confidence: 99%

“…Complex patients with COPD and comorbidities should not be withheld from PR. The deleterious effects of comorbid chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea (OSA) have long been recognised and are frequently encountered as a clinical scenario [1,2]. Although continuous positive airways pressure can be used in order to abolish upper airways obstruction in OSA, it can have adverse effects on pulmonary mechanics in patients with airways obstruction [3].…”

Section: Ckdmentioning

confidence: 99%

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Objectively identified comorbidities in COPD: impact on pulmonary rehabilitation outcomes

et al. 2015

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Section: Ckdsupporting

confidence: 49%

Section: Ckdmentioning

confidence: 99%

Section: Ckdmentioning

confidence: 99%

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Objectively identified comorbidities in COPD: impact on pulmonary rehabilitation outcomes

et al. 2015

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“…Also, data in a clinical population with visual scores showed that airway wall thickening is associated with future cardiovascular events [33]. Similar to CVD, COPD, emphysema and bronchiolitis are accompanied by low-grade systemic inflammation [8,11,34]. There is growing evidence indicating that cardiovascular disease is a major cause of death in COPD patients [35].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

et al. 2014

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Objective The objective of this study was to investigate the association of spirometry and pulmonary CT biomarkers with cardiovascular events. Methods In this lung cancer screening trial 3,080 male participants without a prior cardiovascular event were analysed. Fatal and non-fatal cardiovascular events were included. Spirometry included forced expiratory volume measured in units of one-second percent predicted (FEV 1 %predicted) and FEV 1 divided by forced vital capacity (FVC; FEV 1 /FVC). CT examinations were quantified for coronary artery calcium volume, pulmonary emphysema (perc15) and bronchial wall thickness (pi10). Data were analysed via a Cox proportional hazard analysis, net reclassification improvement (NRI) and C-indices.Results 184 participants experienced a cardiovascular event during a median follow-up of 2.9 years. Age, pack-years and smoking status adjusted hazard ratios were 0.992 (95 % confidence interval (CI) 0.985-0.999) for FEV 1 %predicted, 1.000 (95%CI 0.986-1.015) for FEV 1 /FVC, 1.014 (95%CI 1.005-1.023) for perc15 per 10 HU, and 1.269 (95%CI 1.024-1.573) for pi10 per 1 mm. The incremental C-index (<0.015) and NRI (<2.8 %) were minimal. Coronary artery calcium volume had a hazard ratio of 1.046 (95%CI 1.034-1.058) per 100 mm 3 , an increase in C-index of 0.076 and an NRI of 16.9 % (P<0.0001). Conclusions Pulmonary CT biomarkers and spirometry measurements were significantly associated with cardiovascular events, but did not contain clinically relevant independent prognostic information for cardiovascular events. Key Points • Pulmonary CT biomarkers and spirometry are associated with cardiovascular events • These pulmonary measurements do not contain clinically relevant independent prognostic information • Only coronary calcium score improved cardiovascular risk prediction above age and smoking

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“…Furthermore, systemic disease manifestations and acute exacerbations influence disease burden and mortality risk 3. Extending the classical descriptions of the ‘pink puffer’ and ‘blue bloater’, recent unbiased statistical approaches4, 5 support the concept that body weight and body composition discriminate pulmonary phenotypes and are predictors of outcome. Extra‐pulmonary degenerative manifestations that may occur in COPD include osteoporosis6 and muscle wasting.…”

Section: Introductionmentioning

confidence: 98%

Cachexia in chronic obstructive pulmonary disease: new insights and therapeutic perspective

Sanders¹,

Kneppers²,

Bool³

et al. 2015

Journal of Cachexia, Sarcopenia and Muscle

111

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Cachexia and muscle wasting are well recognized as common and partly reversible features of chronic obstructive pulmonary disease (COPD), adversely affecting disease progression and prognosis. This argues for integration of weight and muscle maintenance in patient care. In this review, recent insights are presented in the diagnosis of muscle wasting in COPD, the pathophysiology of muscle wasting, and putative mechanisms involved in a disturbed energy balance as cachexia driver. We discuss the therapeutic implications of these new insights for optimizing and personalizing management of COPD‐induced cachexia.

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Clusters of Comorbidities Based on Validated Objective Measurements and Systemic Inflammation in Patients with Chronic Obstructive Pulmonary Disease

Cited by 693 publications

References 48 publications

Objectively identified comorbidities in COPD: impact on pulmonary rehabilitation outcomes

Objectively identified comorbidities in COPD: impact on pulmonary rehabilitation outcomes

Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

Cachexia in chronic obstructive pulmonary disease: new insights and therapeutic perspective

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