Current situation of asthma-COPD overlap syndrome (ACOS) in Chinese patients older than 40 years with airflow limitation: rationale and design for a multicenter, cross-sectional trial (study protocol)

Kang, Jian; Yao, Wan-zhen; Cai, Baiqiang; Chen, Ping; Xia, Ling; Shang, Hongyan

doi:10.21037/jtd.2016.12.108

Cited by 5 publications

(9 citation statements)

References 36 publications

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“…The ICSs may be administered for treating the mild to moderate type of ACOS [ 13 , 46 ]. The ICSs [ 47 ] may improve poor lung function [ 28 ]; thus, attenuating the hypoxemia level [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…The hypoxemia status causes the systemic inflammation, associated [ 9 ] with Interferon gamma (IFNγ), the tumor necrosis factor-alpha (TNF-α) [ 10 ], and oxidative stress [ 11 ] leading to direct neuronal damage, as well as depletion of neurotransmitters because of the dysfunction of oxygen-dependent enzymes in chronic obstructive pulmonary disease (COPD) [ 12 ]. ACOS [ 13 ] is the concurrent occurrence of asthma [ 9 ] and COPD [ 14 ]. The high frequency of ACOS [ 15 ] with exacerbation aggravate systemic inflammation [ 12 ] and hypoxemia [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Effect of the asthma-chronic obstructive pulmonary disease syndrome on the stroke, Parkinson's disease, and dementia: a national cohort study

et al. 2017

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BackgroundTo evaluate the association of asthma–chronic obstructive pulmonary disease syndrome (ACOS) with neurodegenerative diseases (stroke, Parkinson's disease and dementia) and the role of the steroids in the neurodegenerative diseases among the ACOS cohort.Materials and MethodsComparison of the ACOS cohort (N = 10,260) with the non-ACOS cohort (n = 20,513) based on the patients aged ≧40 years in the National Health Insurance Research Database from January 1, 2000 to December 31, 2010. These patients follow up to diagnosis of neurodegenerative diseases or the December 31, 2011; using multivariable Cox proportional hazards models.ResultsAfter adjustment for potential confounders, the [adjusted hazard ratio (aHR), 95% confidence interval (CI)] in the ACOS cohort were [1.39, 1.28–1.50] [1.56, 1.34–1.81] and [1.43, 1.29–1.59] for stroke, Parkinson's disease, dementia; respectively. The [aHR, 95% CI] for ACOS cohort with (inhaler corticosteroids ≧0.13 gram/ oral steroids ≧0.08gram) were with less risk (all aHR<1, p values <0.05) for these 3 neurodegenerative diseases except Parkinson's disease with inhaler corticosteroids >0.43 gram. The risk of stroke and dementia were the lower in patients with < 250 μg/d of a fluticasone equivalent inhaler corticosteroids (aHR = 0.53, 95% CI = 0.35–0.79; aHR = 0.53, 95% CI = 0.31–0.90, respectively).ConclusionsThe ACOS cohort had a higher risk of the neurodegenerative diseases. The lower dose of the inhaler corticosteroids with cumulative dose ≧0.13 gram have the less risk of stroke and dementia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of the asthma-chronic obstructive pulmonary disease syndrome on the stroke, Parkinson's disease, and dementia: a national cohort study

et al. 2017

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“…93 Similar results were reported by other studies. 66,92-94 Montes de Oca et al 66 evidenced that the number of exacerbations was 4.9 times higher in patients with ACO, while Kang et al 94 found that these patients suffered more frequent and more severe exacerbations, resulting in a higher number of hospital admissions.…”

Section: Asthma-copd Overlapmentioning

confidence: 99%

“…In recent years, asthma‐COPD overlap (ACO) is of considerable interest worldwide as it is associated with worse health outcomes compared with COPD or asthma alone …”

Section: Asthma‐copd Overlapmentioning

confidence: 99%

“…In recent years, asthma-COPD overlap (ACO) is of considerable interest worldwide as it is associated with worse health outcomes compared with COPD or asthma alone. [92][93][94] A systematic review conducted by Nielsen et al concluded that ACO patients had more frequent and more severe exacerbations compared to patients with asthma and COPD only. 92 A retrospective study carried out in Taiwan showed that patients with ACO had more exacerbations (35.3%) than patients with asthma (29.0%, P < 0.0001 vs ACO) or COPD alone (18.6%, P < 0.0001 vs ACO).…”

Section: Asthma-copd Overlapmentioning

confidence: 99%

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Risk factors of chronic obstructive pulmonary disease exacerbations

Hogea

Tudorache

Fildan

et al. 2020

Clinical Respiratory J

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Chronic Obstructive Pulmonary Disease (COPD) is a chronic respiratory disease characterised by persistent respiratory symptoms and airflow limitation. COPD has a major impact on public health, mainly because of its increasing prevalence, morbidity and mortality. The natural course of COPD is aggravated by episodes of respiratory symptom worsening termed exacerbations that contribute to disease progression. Acute Exacerbations of COPD (AECOPD) can be triggered by a multitude of different factors, including respiratory tract infections, various exposures, prior exacerbations, non‐adherence to treatment and associated comorbidities. AECOPD are associated with an inexorable decline of lung function and a significantly worse survival outcome. This review will summarise the most important aspects regarding the impact of different factors that contribute to COPD exacerbations.

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Prospective development of practical screening strategies for diagnosis of asthma–COPD overlap

et al. 2019

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Background and objectiveACO is a syndrome with high prevalence. However, a pragmatic diagnostic criterion to differentiate ACO is non‐existent. We aimed to establish an effective model for screening ACO.MethodsA multicentre survey was developed to assess the clinical criteria considered important and applicable by pulmonologists for screening ACO. These experts were asked to take the surveys twice. The expert grading method, analytic hierarchy process and ROC curve were used to establish the model, which was then validated by a cross‐sectional study of 1066 patients. The GINA/GOLD document was the gold standard in assessing this model.ResultsIncreased variability of symptoms, paroxysmal wheezing, dyspnoea, historical diagnosis of COPD or asthma, allergic constitution, exposure to risk factors, the FEV1/FVC < 70% and a positive BDT were important for screening ACO. According to the weight of each criterion, we confirmed that patients meeting six or more of these eight criteria should be considered to have ACO. We called this Chinese screening model for ACO ‘CSMA’. It differentiated patients with ACO with a sensitivity of 83.33%, while the sensitivity of clinician‐driven diagnosis had a sensitivity of only 42.73%.ConclusionCSMA is a workable model for screening ACO and provides a simple tool for clinicians to efficiently diagnose ACO.

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Current situation of asthma-COPD overlap syndrome (ACOS) in Chinese patients older than 40 years with airflow limitation: rationale and design for a multicenter, cross-sectional trial (study protocol)

Cited by 5 publications

References 36 publications

Effect of the asthma-chronic obstructive pulmonary disease syndrome on the stroke, Parkinson's disease, and dementia: a national cohort study

Effect of the asthma-chronic obstructive pulmonary disease syndrome on the stroke, Parkinson's disease, and dementia: a national cohort study

Risk factors of chronic obstructive pulmonary disease exacerbations

Prospective development of practical screening strategies for diagnosis of asthma–COPD overlap

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