Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation最新文献

{"title":"Associations Between Coronary Artery Calcium Score and Exacerbation Risk in BLOCK-COPD.","authors":"R Chad Wade, Sharon X Ling, Erika S Helgeson, Helen Voelker, Wassim W Labaki, Daniel Meza, Oisin O'Corragain, Jennifer Y So, Gerard J Criner, MeiLan K Han, Ravi Kalhan, Robert M Reed, Mark T Dransfield, J Michael Wells","doi":"10.15326/jcopdf.2023.0423","DOIUrl":"10.15326/jcopdf.2023.0423","url":null,"abstract":"<p><strong>Introduction: </strong>In 2019, the Beta-Blockers for the Prevention of Acute Exacerbations of Chronic Obstructive Pulmonary Disease study (BLOCK-COPD) evaluated the effect of metoprolol on exacerbation risk and mortality in a COPD population without indications for beta-blocker use. We hypothesized that an imaging metric of coronary artery disease (CAD), the coronary artery calcium (CAC) score, would predict exacerbation risk and identify a differential response to metoprolol treatment.</p><p><strong>Methods: </strong>The study population includes participants in the BLOCK-COPD study from multiple study sites. Participants underwent clinically indicated thoracic computed tomography (CT) scans ± 12 months from enrollment. The Weston scoring system quantified CAC. Adjusted Cox proportional hazards models evaluated for associations between CAC and time to exacerbation.</p><p><strong>Results: </strong>Data is included for 109 participants. The mean CAC score was 5.1±3.7, and 92 participants (84%) had CAC scores greater than 0. Over a median (interquartile range) follow-up time of 350 (280 to 352) days, there were 61 mild exacerbations and 19 severe/very severe exacerbations. No associations were found between exacerbations of any severity and CAC>0 or total CAC. Associations were observed between total CAC and CAC>0 in the left circumflex (LCx) and time to exacerbation of any severity (adjusted hazard ratio [aHR]=1.39, confidence interval [CI]: 1.08-1.79, <i>p</i>=0.01) and (aHR=1.96, 95% CI: 1.04-3.70, <i>p</i>=0.04), respectively.</p><p><strong>Conclusions: </strong>CAD is a prevalent comorbidity in COPD accounting for significant mortality. Our study confirms the high prevalence of CAD using the CAC score; however, we did not discover an association between CAC and exacerbation risk. We did find novel associations between CAC in the LCx and exacerbation risk which warrant further investigation in larger cohorts.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"101-105"},"PeriodicalIF":2.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10913922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Tobacco Product Use and Health-Related Quality of Life Among Individuals With COPD in Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study.","authors":"Laura M Paulin, Michael J Halenar, Kathryn C Edwards, Kristin Lauten, Kristie Taylor, Mary Brunette, Susanne Tanski, Todd MacKenzie, Cassandra A Stanton, Dorothy Hatsukami, Andrew Hyland, Martin C Mahoney, Ray Niaura, Dennis Trinidad, Carlos Blanco, Wilson Compton, Lisa D Gardner, Heather L Kimmel, K Michael Cummings, Dana Lauterstein, Ester J Roh, Daniela Marshall, James D Sargent","doi":"10.15326/jcopdf.2023.0422","DOIUrl":"10.15326/jcopdf.2023.0422","url":null,"abstract":"<p><strong>Introduction: </strong>We examined the association between tobacco product use and health-related quality of life (HRQoL) among individuals with chronic obstructive pulmonary disease (COPD) in Waves 1-5 of the Population Assessment of Tobacco and Health (PATH) Study.</p><p><strong>Methods: </strong>Adults ≥40 years with an ever COPD diagnosis were included in cross-sectional (Wave 5) and longitudinal (Waves 1 to 5) analyses. Tobacco use included 13 mutually exclusive categories of past 30-day (P30D) single use and polyuse with P30D exclusive cigarette use and ≥5-year cigarette cessation as reference groups. Multivariable linear regression and generalized estimating equations (GEE) were used to examine the association between tobacco use and HRQoL as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 questionnaire.</p><p><strong>Results: </strong>Of 1670 adults, 79.4% ever used cigarettes; mean (standard error [SE]) pack years was 30.9 (1.1). In cross-sectional analysis, P30D exclusive cigarette use, and e-cigarette/cigarette dual use were associated with worse HRQoL compared to ≥5-year cigarette cessation. Compared to P30D exclusive cigarette use, never tobacco use and ≥5-year cigarette cessation were associated with better HRQoL, while e-cigarette/cigarette dual use had worse HRQoL. Longitudinally (n=686), e-cigarette/cigarette dual use was associated with worsening HRQoL compared to both reference groups. Only never tobacco use was associated with higher HRQoL over time compared to P30D exclusive cigarette use.</p><p><strong>Conclusions: </strong>E-cigarette/cigarette dual use was associated with worse HRQoL compared to ≥5-year cigarette cessation and exclusive cigarette use. Never use and ≥5-year cigarette cessation were the only categories associated with higher HRQoL compared to exclusive cigarette use. Findings highlight the importance of complete smoking cessation for individuals with COPD.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"68-82"},"PeriodicalIF":2.3,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10913919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Structure and Risk of Sleep Apnea in SPIROMICS.","authors":"Abigail L Koch, Tracie L Shing, Andrew Namen, David Couper, Benjamin Smith, R Graham Barr, Surya Bhatt, Nirupama Putcha, Aaron Baugh, Amit K Saha, Michelle Ziedler, Alejandro Comellas, Christopher B Cooper, Igor Barjaktarevic, Russell P Bowler, Meilan K Han, Victor Kim, Robert Paine, Richard E Kanner, Jerry A Krishnan, Fernando J Martinez, Prescott G Woodruff, Nadia N Hansel, Eric A Hoffman, Stephen P Peters, Victor E Ortega","doi":"10.15326/jcopdf.2023.0411","DOIUrl":"10.15326/jcopdf.2023.0411","url":null,"abstract":"<p><strong>Rationale: </strong>The SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS) is a prospective cohort study that enrolled 2981 participants with the goal of identifying new chronic obstructive pulmonary disease (COPD) subgroups and intermediate markers of disease progression. Individuals with COPD and obstructive sleep apnea (OSA) experience impaired quality of life and more frequent exacerbations. COPD severity also associates with computed tomography scan-based emphysema and alterations in airway dimensions.</p><p><strong>Objectives: </strong>The objective was to determine whether the combination of lung function and structure influences the risk of OSA among current and former smokers.</p><p><strong>Methods: </strong>Using 2 OSA risk scores, the Berlin Sleep Questionnaire (BSQ), and the DOISNORE50 <i>(Diseases, Observed apnea, Insomnia, Snoring, Neck circumference > 18 inches, Obesity with body mass index [BMI] > 32, R = are you male, Excessive daytime sleepiness, 50 = age ≥ 50)</i> (DIS), 1767 current and former smokers were evaluated for an association of lung structure and function with OSA risk.</p><p><strong>Measurements and main results: </strong>The study cohort's mean age was 63 years, BMI was 28 kg/m2, and forced expiratory volume in 1 second (FEV1) was 74.8% predicted. The majority were male (55%), White (77%), former smokers (59%), and had COPD (63%). A high-risk OSA score was reported in 36% and 61% using DIS and BSQ respectively. There was a 9% increased odds of a high-risk DIS score (odds ratio [OR]=1.09, 95% confidence interval [CI]:1.03-1.14) and nominally increased odds of a high-risk BSQ score for every 10% decrease in FEV1 %predicted (OR=1.04, 95%CI: 0.998-1.09). Lung function-OSA risk associations persisted after additionally adjusting for lung structure measurements (%emphysema, %air trapping, parametric response mapping for functional small airways disease, , mean segmental wall area, tracheal %wall area, dysanapsis) for DIS (OR=1.12, 95%CI:1.03-1.22) and BSQ (OR=1.09, 95%CI:1.01-1.18).</p><p><strong>Conclusions: </strong>Lower lung function independently associates with having high risk for OSA in current and former smokers. Lung structural elements, especially dysanapsis, functional small airways disease, and tracheal %wall area strengthened the effects on OSA risk.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"26-36"},"PeriodicalIF":2.3,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10913931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Any Decrease in Lung Function is Associated With Worse Clinical Outcomes: Post Hoc Analysis of the IMPACT Interventional Trial.","authors":"MeiLan K Han, Gerard J Criner, David M G Halpin, Edward M Kerwin, Lee Tombs, David A Lipson, Fernando J Martinez, Robert A Wise, Dave Singh","doi":"10.15326/jcopdf.2023.0391","DOIUrl":"10.15326/jcopdf.2023.0391","url":null,"abstract":"","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"106-113"},"PeriodicalIF":2.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10913929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Obstructive Pulmonary Disease and Lung Cancer: A Review for Clinicians.","authors":"Gerard J Criner,&nbsp;Alvar Agusti,&nbsp;Hossein Borghaei,&nbsp;Joseph Friedberg,&nbsp;Fernando J Martinez,&nbsp;Curtis Miyamoto,&nbsp;Claus F Vogelmeier,&nbsp;Bartolome R Celli","doi":"10.15326/jcopdf.2022.0296","DOIUrl":"https://doi.org/10.15326/jcopdf.2022.0296","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) and lung cancer are common global causes of morbidity and mortality. Because both diseases share several predisposing risks, the 2 diseases may occur concurrently in susceptible individuals. The diagnosis of COPD has important implications for the diagnostic approach and treatment options if lesions concerning for lung cancer are identified during screening. Importantly, the presence of COPD has significant implications on prognosis and management of patients with lung cancer. In this monograph, we review the mechanistic linkage between lung cancer and COPD, the impact of lung cancer screening on patients at risk, and the implications of the presence of COPD on the approach to the diagnosis and treatment of lung cancer. This manuscript succinctly reviews the epidemiology and common pathogenetic factors for the concurrence of COPD and lung cancer. Importantly for the clinician, it summarizes the indications, benefits, and complications of lung cancer screening in patients with COPD, and the assessment of risk factors for patients with COPD undergoing consideration of various treatment options for lung cancer.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"454-476"},"PeriodicalIF":2.4,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448004/pdf/JCOPDF-9-454.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40562124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Prevalence of Suboptimal Peak Inspiratory Flow in Hospitalized Patients With COPD: A Real-world Study.","authors":"Donald A Mahler,&nbsp;Shaban Demirel,&nbsp;Ramon Hollander,&nbsp;Gokul Gopalan,&nbsp;Asif Shaikh,&nbsp;Cathy D Mahle,&nbsp;Jessica Elder,&nbsp;Curtis Morrison","doi":"10.15326/jcopdf.2022.0291","DOIUrl":"https://doi.org/10.15326/jcopdf.2022.0291","url":null,"abstract":"<p><p>For optimal drug delivery, dry powder inhalers (DPIs) depend on the patient's peak inspiratory flow (PIF) and the internal resistance of the device to create turbulent energy and disaggregate the powder. A suboptimal PIF may lead to ineffective drug inhalation into the lungs. Our objective was to report the prevalence of suboptimal PIF in patients with COPD hospitalized for any reason using 1 or more DPIs. In this real-world, observational, single‑site, retrospective study, PIF was measured for each DPI using the In-Check™ DIAL set to match the resistance of the DPI used by each patient. PIFs <60 and <30L/min were considered suboptimal for low to medium-high- and high-resistance DPIs, respectively. At initial hospitalization, the prevalence of suboptimal PIF was 44.6% in 829 patients (mean age, 71.7 years; 56.8% female); 21.2% were measured during admission for a COPD exacerbation. Suboptimal PIF percentages were 61.0% (38.1±9.5L/min [mean±standard deviation (SD)]) across low to medium-high-resistance DPIs and 17.2% (20.7±4.2L/min) for high-resistance DPIs. Overall, 190/829 patients had 1 or more 30-day all-cause readmission with 253 corresponding PIF measurements. For readmissions, suboptimal PIFs were observed in 49.5% (94/190) of patients. Suboptimal PIF percentages were 65.4% (38.4±9.2L/min) for low to medium-high-resistance DPIs and 19.8% (22.4±3.3L/min) for high-resistance DPIs. As the overall prevalence of suboptimal PIFs in hospitalized patients with COPD varied according to the specific internal resistance of the DPI, these findings may have clinical implications for inhaler selection.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"427-438"},"PeriodicalIF":2.4,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448011/pdf/JCOPDF-9-427.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40481004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal Club: Impaired Ventilatory Efficiency and Exercise Intolerance in Former/Current Smokers With Dyspnea Disproportionate to Their Lung Function: Pathophysiological Insights Gained Through Cardiopulmonary Exercise Testing.","authors":"Ron Balkissoon,&nbsp;Takudzwa Mkorombindo","doi":"10.15326/jcopdf.2022.0344","DOIUrl":"https://doi.org/10.15326/jcopdf.2022.0344","url":null,"abstract":"","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"477-485"},"PeriodicalIF":2.4,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448006/pdf/JCOPDF-9-477.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40556708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of High Sputum Eosinophils in Chronic Obstructive Pulmonary Disease.","authors":"Xiang Wen,&nbsp;Jieqi Peng,&nbsp;Youlan Zheng,&nbsp;Jiaxing Liu,&nbsp;Heshen Tian,&nbsp;Fan Wu,&nbsp;Zihui Wang,&nbsp;Huajing Yang,&nbsp;Zhishan Deng,&nbsp;Shan Xiao,&nbsp;Peiyu Huang,&nbsp;Jianwu Xu,&nbsp;Cuiqiong Dai,&nbsp;Ningning Zhao,&nbsp;Lifei Lu,&nbsp;Jianwei Dai,&nbsp;Bing Li,&nbsp;Pixin Ran,&nbsp;Yumin Zhou","doi":"10.15326/jcopdf.2022.0310","DOIUrl":"https://doi.org/10.15326/jcopdf.2022.0310","url":null,"abstract":"<p><strong>Background: </strong>Eosinophils are involved in the development of chronic obstructive pulmonary disease (COPD) and inhaled corticosteroid responsiveness. We evaluated clinical predictors of high sputum eosinophil levels in a COPD cohort in China.</p><p><strong>Methods: </strong>We conducted an observational, prospective, population-based, cross-sectional study. Participants were tested for COPD and underwent spirometry, computed tomography scans, and a blood test. Participants also produced induced sputum and responded to an information-gathering questionnaire. High sputum eosinophils were defined as ≥3.0%. Multivariate logistic regression was used to identify predictors of high sputum eosinophil levels.</p><p><strong>Results: </strong>We recruited 895 patients with complete and quality control data. The median percentage of sputum eosinophil abundance was 2.00% (interquartile range: 0.75-5.00) and the prevalence of COPD with high sputum eosinophils was 38.0%. Covariance analysis indicated that the high sputum eosinophil group had lower lung function, more severe emphysema, and air trapping. Multivariate logistic regression indicated that high blood eosinophil levels, severe respiratory symptoms, being a former smoker, and a family history of respiratory diseases were associated with high sputum eosinophil levels.</p><p><strong>Conclusion: </strong>High blood eosinophil levels, severe respiratory symptoms, being a former smoker, and a family history of respiratory diseases may be predictors of high sputum eosinophil levels in Chinese COPD patients. High sputum eosinophils were associated with lower lung function, more emphysema, and gas trapping.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"413-426"},"PeriodicalIF":2.4,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448012/pdf/JCOPDF-9-413.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40567534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Two Interventional Strategies on Improving Continuous Positive Airway Pressure Adherence in Existing COPD and Obstructive Sleep Apnea Patients: The O2VERLAP Study.","authors":"Sergio Martinez,&nbsp;Jamie Sullivan,&nbsp;Cara Pasquale,&nbsp;Bill Clark,&nbsp;Elisha Malanga,&nbsp;Sean Deering,&nbsp;Lin Liu,&nbsp;Carl J Stepnowsky","doi":"10.15326/jcopdf.2022.0293","DOIUrl":"https://doi.org/10.15326/jcopdf.2022.0293","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a sleep disorder prevalent in >10% of individuals diagnosed with chronic obstructive pulmonary disease (COPD). Continuous positive airway pressure (CPAP) is the first-line therapy for OSA, but many do not use it enough during sleep to effectively manage OSA. The O₂VERLAP study compared <i>proactive care</i> (PC)-structured web-based peer-coaching education and support intervention versus <i>reactive care</i> (RC)-education and support based on limited scheduled interactions and patient-initiated contacts.</p><p><strong>Methods: </strong>Participants were primarily recruited from patient communities (COPD, OSA, and the National Patient-Centered Outcomes Research Network [PCORnet]) through electronic methods. Inclusion criteria: ≥40 years old, diagnosis of both COPD and OSA, and currently using CPAP. Participants were then randomly assigned to either the PC or RC group, with outcomes assessed at baseline and 6 and 12 weeks. The primary study outcome was CPAP adherence (hours of use/night) and secondary outcomes were daytime functioning, sleep quality, and daytime sleepiness. Changes in outcomes over time were examined using random effects models.</p><p><strong>Results: </strong>The study enrolled 332 participants of which 294 were randomized. While groups differed significantly in CPAP adherence at baseline (PC: 6.1±3.1, RC: 7.3±2.4 hours/night; <i>P</i><0.001), there were no significant differences in change of primary and secondary outcomes at either 6 or 12 weeks.</p><p><strong>Conclusion: </strong>In this group of patients with both COPD and OSA on CPAP therapy, no difference was found between the provision of PC and RC. The study did find unexpectedly high baseline CPAP adherence levels, which suggests that any improvement from the intervention would have been very small and difficult to detect.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"394-412"},"PeriodicalIF":2.4,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448010/pdf/JCOPDF-9-394.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40569544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatable Traits in Misdiagnosed Chronic Obstructive Pulmonary Disease: Data from the Akershus Cardiac Examination 1950 Study.","authors":"Nina Faksvåg Caspersen,&nbsp;Vidar Søyseth,&nbsp;Magnus Nakrem Lyngbakken,&nbsp;Trygve Berge,&nbsp;Inger Ariansen,&nbsp;Arnljot Tveit,&nbsp;Helge Røsjø,&nbsp;Gunnar Einvik","doi":"10.15326/jcopdf.2021.0265","DOIUrl":"https://doi.org/10.15326/jcopdf.2021.0265","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is often misdiagnosed. We aimed to estimate the prevalence of misdiagnosed COPD in middle-aged Norwegians, and to assess potentially treatable clinical traits in over- and undiagnosed individuals.</p><p><strong>Methods and findings: </strong>The Akershus Cardiac Examination (ACE) 1950 Study is a population-based study of the 1950 birth cohort of Akershus county including 3706 participants aged 62-65 years at baseline. COPD was defined as a forced expiratory volume in 1 second (FEV₁) to forced vital capacity (FVC) ratio < lower limit of normal (LLN). Misdiagnosed COPD was defined according to self-reported COPD. A total of 259 (7.1%) participants had spirometry confirmed COPD. Of these, only 72 (28%) reported having COPD, thus 187 (72%) were undiagnosed. A total of 92 (2.5%) of the 164 particpants who reported having COPD had an FEV₁/FVC ratio ≥ LLN and were overdiagnosed. They had lower lung function, and more respiratory symptoms, self-reported asthma, eosinophils, and sleep apnea than other non-COPD participants . The main predictor of being overdiagnosed was overweight. Spirometry in participants reporting wheezing or cough and current smokers or participants with ≥20 tobacco pack-year history would have identified 85% of the undiagnosed cases.</p><p><strong>Conclusion: </strong>Both over- and underdiagnosis of COPD is frequent. Undiagnosed individuals have better lung function and less symptoms, but similar prevalence of comorbidities and systemic inflammation. Overdiagnosed individuals have treatable traits including asthma, eosinophilic inflammation, and sleep apnea. The main predictor of being overdiagnosed was being overweight.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"165-180"},"PeriodicalIF":2.4,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166336/pdf/JCOPDF-9-165.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39917966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}