Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/46391
Title: | Identification and prospective validation of clinically relevant chronic obstructive pulmonary disease (COPD) subtypes |
Author: | García Aymerich, Judith Gomez, Federico P. Benet Mora, Marta Farrero, Eva Basagaña, Xavier Gayete, Àngel Pare i Bardera, J. Carles Freixa, Xavier Ferrer, Jaume Ferrer Monreal, Antonio Roca Elias, Josep Galdiz, Juan B. Sauleda, Jaume Monsó, Eduard Gea Guiral, Joaquim Barberà i Mir, Joan Albert Agustí García-Navarro, Àlvar Antó i Boqué, Josep Maria |
Keywords: | Malalties de l'aparell respiratori Malalties pulmonars obstructives cròniques Assaigs clínics Respiratory organs diseases Chronic obstructive pulmonary diseases Clinical trials |
Issue Date: | 21-Dec-2010 |
Publisher: | BMJ Publishing Group |
Abstract: | Background Chronic obstructive pulmonary disease (COPD) is increasingly considered a heterogeneous condition. It was hypothesised that COPD, as currently defined, includes different clinically relevant subtypes. Methods To identify and validate COPD subtypes, 342 subjects hospitalised for the first time because of a COPD exacerbation were recruited. Three months after discharge, when clinically stable, symptoms and quality of life, lung function, exercise capacity, nutritional status, biomarkers of systemic and bronchial inflammation, sputum microbiology, CT of the thorax and echocardiography were assessed. COPD groups were identified by partitioning cluster analysis and validated prospectively against cause-specific hospitalisations and all-cause mortality during a 4 year follow-up. Results Three COPD groups were identified: group 1 (n ¼ 126, 67 years) was characterised by severe airflow limitation (postbronchodilator forced expiratory volume in 1 s (FEV 1 ) 38% predicted) and worse performance in most of the respiratory domains of the disease; group 2 (n ¼ 125, 69 years) showed milder airflow limitation (FEV 1 63% predicted); and group 3 (n ¼ 91, 67 years) combined a similarly milder airflow limitation (FEV 1 58% predicted) with a high proportion of obesity, cardiovascular disorders, iabetes and systemic inflammation. During follow-up, group 1 had more frequent hospitalisations due to COPD (HR 3.28, p < 0.001) and higher all-cause mortality (HR 2.36, p ¼ 0.018) than the other two groups, whereas group 3 had more admissions due to cardiovascular disease (HR 2.87, p ¼ 0.014). Conclusions In patients with COPD recruited at their first hospitalisation, three different COPD subtypes were identified and prospectively validated:"severe respiratory COPD","moderate respiratory COPD", and"systemic COPD' |
Note: | Reproducció del document publicat a: http://dx.doi.org/10.1136/thx.2010.154484 |
It is part of: | Thorax, 2010, vol. 66, p. 430-437 |
URI: | http://hdl.handle.net/2445/46391 |
Related resource: | http://dx.doi.org/10.1136/thx.2010.154484 |
ISSN: | 0040-6376 |
Appears in Collections: | Articles publicats en revistes (Medicina) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
609851.pdf | 535.18 kB | Adobe PDF | View/Open |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.