Reversible Airflow Obstruction Predicts Future Chronic Obstructive Pulmonary Disease Development in the SPIROMICS Cohort : An Observational Cohort Study
Rationale: Chronic obstructive pulmonary disease (COPD) is defined by fixed spirometric ratio, FEV1/FVC < 0.70 after inhaled bronchodilators. However, the implications of variable obstruction (VO), in which the prebronchodilator FEV1/FVC ratio is less than 0.70 but increases to 0.70 or more after inhaled bronchodilators, have not been determined. Objectives: We explored differences in physiology, exacerbations, and health status in participants with VO compared with reference participants without obstruction. Methods: Data from the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort were obtained. Participants with VO were compared with reference participants without obstruction. Measurements and Main Results: We assessed differences in baseline radiographic emphysema and small airway disease at study entry, baseline, and change in lung function by spirometry, functional capacity by 6-minute walk, health status using standard questionnaires, exacerbation rates, and progression to COPD between the two groups. All models were adjusted for participant characteristics, asthma history, and tobacco exposure. We assessed 175 participants with VO and 603 reference participants without obstruction. Participants with VO had 6.2 times the hazard of future development of COPD controlling for other factors (95% confidence interval, 4.6-8.3; P < 0.001). Compared with reference participants, the VO group had significantly lower baseline pre- and post-bronchodilator (BD) FEV1, and greater decline over time in post-BD FEV1, and pre- and post-BD FVC. There were no significant differences in exacerbations between groups. Conclusions: Significant risk for future COPD development exists for those with pre- but not post-BD airflow obstruction. These findings support consideration of expanding spirometric criteria defining COPD to include pre-BD obstruction. Clinical trial registered with www.clinicaltrials.gov (NCT01969344).
| Errataetall: |
CommentIn: Am J Respir Crit Care Med. 2022 Sep 1;206(5):522-524. - PMID 35579677 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:206 |
|---|---|
| Enthalten in: |
American journal of respiratory and critical care medicine - 206(2022), 5 vom: 01. Sept., Seite 554-562 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Buhr, Russell G [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 08.09.2022 Date Revised 03.04.2024 published: Print ClinicalTrials.gov: NCT01969344 CommentIn: Am J Respir Crit Care Med. 2022 Sep 1;206(5):522-524. - PMID 35579677 Citation Status MEDLINE |
|---|
| doi: |
10.1164/rccm.202201-0094OC |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM340777982 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM340777982 | ||
| 003 | DE-627 | ||
| 005 | 20240403234743.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1164/rccm.202201-0094OC |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1362.xml |
| 035 | |a (DE-627)NLM340777982 | ||
| 035 | |a (NLM)35549640 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Buhr, Russell G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Reversible Airflow Obstruction Predicts Future Chronic Obstructive Pulmonary Disease Development in the SPIROMICS Cohort |b An Observational Cohort Study |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 08.09.2022 | ||
| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT01969344 | ||
| 500 | |a CommentIn: Am J Respir Crit Care Med. 2022 Sep 1;206(5):522-524. - PMID 35579677 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Rationale: Chronic obstructive pulmonary disease (COPD) is defined by fixed spirometric ratio, FEV1/FVC < 0.70 after inhaled bronchodilators. However, the implications of variable obstruction (VO), in which the prebronchodilator FEV1/FVC ratio is less than 0.70 but increases to 0.70 or more after inhaled bronchodilators, have not been determined. Objectives: We explored differences in physiology, exacerbations, and health status in participants with VO compared with reference participants without obstruction. Methods: Data from the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort were obtained. Participants with VO were compared with reference participants without obstruction. Measurements and Main Results: We assessed differences in baseline radiographic emphysema and small airway disease at study entry, baseline, and change in lung function by spirometry, functional capacity by 6-minute walk, health status using standard questionnaires, exacerbation rates, and progression to COPD between the two groups. All models were adjusted for participant characteristics, asthma history, and tobacco exposure. We assessed 175 participants with VO and 603 reference participants without obstruction. Participants with VO had 6.2 times the hazard of future development of COPD controlling for other factors (95% confidence interval, 4.6-8.3; P < 0.001). Compared with reference participants, the VO group had significantly lower baseline pre- and post-bronchodilator (BD) FEV1, and greater decline over time in post-BD FEV1, and pre- and post-BD FVC. There were no significant differences in exacerbations between groups. Conclusions: Significant risk for future COPD development exists for those with pre- but not post-BD airflow obstruction. These findings support consideration of expanding spirometric criteria defining COPD to include pre-BD obstruction. Clinical trial registered with www.clinicaltrials.gov (NCT01969344) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a COPD | |
| 650 | 4 | |a multilevel modeling | |
| 650 | 4 | |a pulmonary physiology | |
| 650 | 4 | |a spirometry | |
| 650 | 4 | |a survival analysis | |
| 650 | 7 | |a Bronchodilator Agents |2 NLM | |
| 700 | 1 | |a Barjaktarevic, Igor Z |e verfasserin |4 aut | |
| 700 | 1 | |a Quibrera, P Miguel |e verfasserin |4 aut | |
| 700 | 1 | |a Bateman, Lori A |e verfasserin |4 aut | |
| 700 | 1 | |a Bleecker, Eugene R |e verfasserin |4 aut | |
| 700 | 1 | |a Couper, David J |e verfasserin |4 aut | |
| 700 | 1 | |a Curtis, Jeffrey L |e verfasserin |4 aut | |
| 700 | 1 | |a Dolezal, Brett A |e verfasserin |4 aut | |
| 700 | 1 | |a Han, MeiLan K |e verfasserin |4 aut | |
| 700 | 1 | |a Hansel, Nadia N |e verfasserin |4 aut | |
| 700 | 1 | |a Krishnan, Jerry A |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez, Fernando J |e verfasserin |4 aut | |
| 700 | 1 | |a McKleroy, William |e verfasserin |4 aut | |
| 700 | 1 | |a Paine, Robert |c 3rd |e verfasserin |4 aut | |
| 700 | 1 | |a Rennard, Stephen I |e verfasserin |4 aut | |
| 700 | 1 | |a Tashkin, Donald P |e verfasserin |4 aut | |
| 700 | 1 | |a Woodruff, Prescott G |e verfasserin |4 aut | |
| 700 | 1 | |a Kanner, Richard E |e verfasserin |4 aut | |
| 700 | 1 | |a Cooper, Christopher B |e verfasserin |4 aut | |
| 700 | 0 | |a SPIROMICS Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Alexis, Neil E |e investigator |4 oth | |
| 700 | 1 | |a Anderson, Wayne H |e investigator |4 oth | |
| 700 | 1 | |a Arjomandi, Mehrdad |e investigator |4 oth | |
| 700 | 1 | |a Barr, R Graham |e investigator |4 oth | |
| 700 | 1 | |a Bhatt, Surya P |e investigator |4 oth | |
| 700 | 1 | |a Boucher, Richard C |e investigator |4 oth | |
| 700 | 1 | |a Bowler, Russell P |e investigator |4 oth | |
| 700 | 1 | |a Christenson, Stephanie A |e investigator |4 oth | |
| 700 | 1 | |a Comellas, Alejandro P |e investigator |4 oth | |
| 700 | 1 | |a Criner, Gerard J |e investigator |4 oth | |
| 700 | 1 | |a Crystal, Ronald G |e investigator |4 oth | |
| 700 | 1 | |a Doerschuk, Claire M |e investigator |4 oth | |
| 700 | 1 | |a Dransfield, Mark T |e investigator |4 oth | |
| 700 | 1 | |a Drummond, Brad |e investigator |4 oth | |
| 700 | 1 | |a Freeman, Christine M |e investigator |4 oth | |
| 700 | 1 | |a Galban, Craig |e investigator |4 oth | |
| 700 | 1 | |a Hastie, Annette T |e investigator |4 oth | |
| 700 | 1 | |a Hoffman, Eric A |e investigator |4 oth | |
| 700 | 1 | |a Huang, Yvonne |e investigator |4 oth | |
| 700 | 1 | |a Kaner, Robert J |e investigator |4 oth | |
| 700 | 1 | |a Kleerup, Eric C |e investigator |4 oth | |
| 700 | 1 | |a LaVange, Lisa M |e investigator |4 oth | |
| 700 | 1 | |a Lazarus, Stephen C |e investigator |4 oth | |
| 700 | 1 | |a Meyers, Deborah A |e investigator |4 oth | |
| 700 | 1 | |a Moore, Wendy C |e investigator |4 oth | |
| 700 | 1 | |a Newell, John D |c Jr |e investigator |4 oth | |
| 700 | 1 | |a Paulin, Laura |e investigator |4 oth | |
| 700 | 1 | |a Peters, Stephen P |e investigator |4 oth | |
| 700 | 1 | |a Pirozzi, Cheryl |e investigator |4 oth | |
| 700 | 1 | |a Putcha, Nirupama |e investigator |4 oth | |
| 700 | 1 | |a Oelsner, Elizabeth C |e investigator |4 oth | |
| 700 | 1 | |a O'Neal, Wanda K |e investigator |4 oth | |
| 700 | 1 | |a Ortega, Victor E |e investigator |4 oth | |
| 700 | 1 | |a Raman, Sanjeev |e investigator |4 oth | |
| 700 | 1 | |a Wells, J Michael |e investigator |4 oth | |
| 700 | 1 | |a Wise, Robert A |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of respiratory and critical care medicine |d 1994 |g 206(2022), 5 vom: 01. Sept., Seite 554-562 |w (DE-627)NLM074657305 |x 1535-4970 |7 nnns |
| 773 | 1 | 8 | |g volume:206 |g year:2022 |g number:5 |g day:01 |g month:09 |g pages:554-562 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1164/rccm.202201-0094OC |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 206 |j 2022 |e 5 |b 01 |c 09 |h 554-562 | ||