AIM: To investigate whether there is a significant relationship between an increased frequency of exacerbations and the rate of forced expiratory volume in 1s (FEV(1)) decline in COPD patients. METHODS-MEASUREMENTS: About 102 COPD patients (44 smokers, 58 ex-smokers) participated in a 3-year prospective study. Exacerbations were identified as worsening of patient's respiratory symptoms as recorded on diary cards. Spirometry was performed every 6 months. The effect of frequent exacerbations on lung function was investigated using random effects models. RESULTS: The median (mean(95% CI)) annual exacerbation rate was 2.85 (3.1 (2.7-3.6)). Patients with an annual exacerbation rate over the median rate had significantly lower baseline post-bronchodilation FEV(1)(%pred), higher MRC dyspnoea score and chronic cough compared to patients who had an annual exacerbation rate less than the median. The average annual rate of FEV(1)(%pred), adjusted for smoking decline (DeltaFEV(1)), was found significantly increased in frequent compared to infrequent exacerbators (P=0.017). The highest DeltaFEV(1) was observed in smokers frequent exacerbators and a significant interaction between exacerbation frequency and DeltaFEV(1) was also observed in ex-smokers. CONCLUSIONS: Our findings suggest that an increased frequency of exacerbations is significantly associated with FEV(1) decline even in ex-smokers. Thus, smoking and frequent exacerbations may have both negative impact on lung function. Smoking cessation and prevention of exacerbations should be a major target in COPD.
AIM: To investigate whether there is a significant relationship between an increased frequency of exacerbations and the rate of forced expiratory volume in 1s (FEV(1)) decline in COPDpatients. METHODS-MEASUREMENTS: About 102 COPDpatients (44 smokers, 58 ex-smokers) participated in a 3-year prospective study. Exacerbations were identified as worsening of patient's respiratory symptoms as recorded on diary cards. Spirometry was performed every 6 months. The effect of frequent exacerbations on lung function was investigated using random effects models. RESULTS: The median (mean(95% CI)) annual exacerbation rate was 2.85 (3.1 (2.7-3.6)). Patients with an annual exacerbation rate over the median rate had significantly lower baseline post-bronchodilation FEV(1)(%pred), higher MRC dyspnoea score and chronic cough compared to patients who had an annual exacerbation rate less than the median. The average annual rate of FEV(1)(%pred), adjusted for smoking decline (DeltaFEV(1)), was found significantly increased in frequent compared to infrequent exacerbators (P=0.017). The highest DeltaFEV(1) was observed in smokers frequent exacerbators and a significant interaction between exacerbation frequency and DeltaFEV(1) was also observed in ex-smokers. CONCLUSIONS: Our findings suggest that an increased frequency of exacerbations is significantly associated with FEV(1) decline even in ex-smokers. Thus, smoking and frequent exacerbations may have both negative impact on lung function. Smoking cessation and prevention of exacerbations should be a major target in COPD.
Authors: Laura M Paulin; Gregory B Diette; Paul D Blanc; Nirupama Putcha; Mark D Eisner; Richard E Kanner; Andrew J Belli; Stephanie Christenson; Donald P Tashkin; MeiLan Han; R Graham Barr; Nadia N Hansel Journal: Am J Respir Crit Care Med Date: 2015-03-01 Impact factor: 21.405
Authors: Mark T Dransfield; Ken M Kunisaki; Matthew J Strand; Antonio Anzueto; Surya P Bhatt; Russell P Bowler; Gerard J Criner; Jeffrey L Curtis; Nicola A Hanania; Hrudaya Nath; Nirupama Putcha; Sarah E Roark; Emily S Wan; George R Washko; J Michael Wells; Christine H Wendt; Barry J Make Journal: Am J Respir Crit Care Med Date: 2017-02-01 Impact factor: 21.405
Authors: Anand S Iyer; Surya P Bhatt; Jeffrey J Garner; J Michael Wells; Jennifer L Trevor; Neha M Patel; deNay Kirkpatrick; John C Williams; Mark T Dransfield Journal: Ann Am Thorac Soc Date: 2016-02