Risk of Nonlower Respiratory Serious Adverse Events Following COPD Exacerbations in the 4-year UPLIFT® Trial

Halpin, David; Decramer, Marc; Celli, Bartolomé R.; Kesten, Steven; Leimer, Inge; Tashkin, Donald P.

doi:10.1007/s00408-011-9301-8

Cited by 71 publications

(74 citation statements)

References 18 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A review of studies of patients hospitalized for COPD exacerbations found that up to 55% of patients had a history of cardiovascular disease 33. Exacerbations of COPD have a profound effect on patients’ cardiovascular status,33–35 and the increase in cardiac events after the first exacerbation is irrespective of the patient’s cardiac history 36. Markers of myocardial injury, including raised troponin, chest pain, and serial electrocardiogram changes, are commonly observed in patients admitted to hospital with exacerbations of COPD 33,34.…”

Section: What Are the Likely Clinical Outcomes Of Severe Copd Exacerbmentioning

confidence: 99%

Impact and prevention of severe exacerbations of COPD: a review of the evidence

Halpin¹,

Miravitlles²,

Metzdorf³

et al. 2017

COPD

182

159

View full text Add to dashboard Cite

Severe exacerbations of COPD, ie, those leading to hospitalization, have profound clinical implications for patients and significant economic consequences for society. The prevalence and burden of severe COPD exacerbations remain high, despite recognition of the importance of exacerbation prevention and the availability of new treatment options. Severe COPD exacerbations are associated with high mortality, have negative impact on quality of life, are linked to cardiovascular complications, and are a significant burden on the health-care system. This review identified risk factors that contribute to the development of severe exacerbations, treatment options (bronchodilators, antibiotics, corticosteroids [CSs], oxygen therapy, and ventilator support) to manage severe exacerbations, and strategies to prevent readmission to hospital. Risk factors that are amenable to change have been highlighted. A number of bronchodilators have demonstrated successful reduction in risk of severe exacerbations, including long-acting muscarinic antagonist or long-acting β2-agonist mono- or combination therapies, in addition to vaccination, mucolytic and antibiotic therapy, and nonpharmacological interventions, such as pulmonary rehabilitation. Recognition of the importance of severe exacerbations is an essential step in improving outcomes for patients with COPD. Evidence-based approaches to prevent and manage severe exacerbations should be implemented as part of targeted strategies for disease management.

show abstract

Section: What Are the Likely Clinical Outcomes Of Severe Copd Exacerbmentioning

confidence: 99%

Impact and prevention of severe exacerbations of COPD: a review of the evidence

Halpin¹,

Miravitlles²,

Metzdorf³

et al. 2017

COPD

182

159

View full text Add to dashboard Cite

show abstract

“…Systemic inflammation is thought to accelerate atherosclerosis and thereby increase the risk of heart failure 53. In the Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT) trial there was an increase in cardiac failure at 30 days (RR: 14.08) and 180 days (RR: 10.71) post-exacerbation 54. This risk was conferred even in those without known cardiovascular disease at baseline.…”

Section: Heart Failurementioning

confidence: 99%

Epidemiology and clinical impact of major comorbidities in patients with COPD

Smith¹,

Wrobel²

2014

COPD

314

230

View full text Add to dashboard Cite

Comorbidities are frequent in chronic obstructive pulmonary disease (COPD) and significantly impact on patients' quality of life, exacerbation frequency, and survival. There is increasing evidence that certain diseases occur in greater frequency amongst patients with COPD than in the general population, and that these comorbidities significantly impact on patient outcomes. Although the mechanisms are yet to be defined, many comorbidities likely result from the chronic inflammatory state that is present in COPD. Common problems in the clinical management of COPD include recognizing new comorbidities, determining the impact of comorbidities on patient symptoms, the concurrent treatment of COPD and comorbidities, and accurate prognostication. The majority of comorbidities in COPD should be treated according to usual practice, and specific COPD management is infrequently altered by the presence of comorbidities. Unfortunately, comorbidities are often under-recognized and under-treated. This review focuses on the epidemiology of ten major comorbidities in patients with COPD. Further, we emphasize the clinical impact upon prognosis and management considerations. This review will highlight the importance of comorbidity identification and management in the practice of caring for patients with COPD.

show abstract

“…Exacerbation of COPD is another factor affecting disease severity and has been defined as an acute event characterized by a worsening of the patient’s respiratory symptoms beyond normal day-to-day variations that leads to a change in medication [1]. Because patient recovery is often not complete after exacerbations, exacerbations have an important predictive role for COPD prognosis [5,6]. The frequency of exacerbations increases with the severity of disease and if a patient has had two or more acute events during the previous year, the patient is considered high risk [7,8].…”

Section: Introductionmentioning

confidence: 99%

Serum Uric Acid Levels and Uric Acid/Creatinine Ratios in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients: Are These Parameters Efficient Predictors of Patients at Risk for Exacerbation and/or Severity of Disease?

et al. 2016

View full text Add to dashboard Cite

BackgroundSerum uric acid (sUA) levels were previously found to be correlated with hypoxic states. We aimed to determine the levels of sUA and sUA/creatinine ratios in stable COPD patients and to evaluate whether sUA level and sUA/creatinine ratio can be used as predictors of exacerbation risk and disease severity.Material/MethodsThis cross-sectional study included stable COPD patients and healthy controls. The sUA levels and sUA/creatinine ratios in each group were evaluated and their correlations with the study parameters were investigated. ROC analyses for exacerbation risk and disease severity were reported.ResultsThe study included 110 stable COPD patients and 52 healthy controls. The mean sUA levels and sUA/creatinine ratios were significantly higher in patients with COPD compared to healthy controls. The most common comorbidities in COPD patients were hypertension, diabetes, and coronary artery disease. While sUA levels were significantly higher in patients with hypertension (p=0.002) and malignancy (p=0.033), sUA/creatinine ratios was higher in patients with malignancy (p=0.004). The ROC analyses indicated that sUA/creatinine ratios can be more useful than sUA levels in predicting exacerbation risk (AUC, 0.586 vs. 0.426) and disease severity (AUC, 0.560 vs. 0.475) especially at higher cut-off values, but with low specificity.ConclusionsOur study suggested that sUA levels and sUA/creatinine ratios increased in patients with stable COPD, especially among patients with certain comorbidities compared to healthy controls. At higher cut-off values, sUA levels and especially sUA/creatinine ratios, might be useful in predicting COPD exacerbation risk and disease severity. Also, their association with comorbidities, especially with malignancy and hypertension, may benefit from further investigation.

show abstract

Risk of Nonlower Respiratory Serious Adverse Events Following COPD Exacerbations in the 4-year UPLIFT® Trial

Cited by 71 publications

References 18 publications

Impact and prevention of severe exacerbations of COPD: a review of the evidence

Impact and prevention of severe exacerbations of COPD: a review of the evidence

Epidemiology and clinical impact of major comorbidities in patients with COPD

Serum Uric Acid Levels and Uric Acid/Creatinine Ratios in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients: Are These Parameters Efficient Predictors of Patients at Risk for Exacerbation and/or Severity of Disease?

Contact Info

Product

Resources

About