Juan P de Torres1, Victor Pinto-Plata2, Ciro Casanova3, Hanna Mullerova4, Elizabeth Córdoba-Lanús5, Mercedes Muros de Fuentes6, Armando Aguirre-Jaime5, Bartolome R Celli2. 1. Respiratory Research Unit, Departments, Hospital Ntra Sra de Candelaria, Tenerife, Spain. Electronic address: jupa65@hotmail.com. 2. Pulmonary and Critical Care Department, Caritas St Elizabeth's Medical Center, Boston, MA. 3. Pulmonary, Departments, Hospital Ntra Sra de Candelaria, Tenerife, Spain. 4. GlaxoSmithKline, Worldwide Epidemiology Department, London, UK. 5. Respiratory Research Unit, Departments, Hospital Ntra Sra de Candelaria, Tenerife, Spain. 6. Biochemical Analysis, Departments, Hospital Ntra Sra de Candelaria, Tenerife, Spain.
Abstract
BACKGROUND: Serum levels of C-reactive protein (CRP) are increased in patients with COPD and correlate modestly with variables predictive of outcomes. In epidemiologic studies, CRP level is associated with all-cause mortality in patients with mild-to-moderate disease. OBJECTIVE: To determine if CRP levels are associated with survival in patients with moderate to very severe COPD in comparison with other well-known prognostic parameters of the disease. METHODS: In 218 stable patients with COPD, we measured baseline serum CRP level, BODE (body mass index, obstruction, dyspnea, and exercise capacity) index and its components, arterial oxygenation (Pao(2)), inspiratory capacity (IC) to total lung capacity (TLC) ratio, and Charlson comorbidity score. We followed up the patients over time and evaluated the strength of the association between the variables and all-cause mortality. RESULTS: During the follow-up time (median, 36 months; 25th to 75th percentiles, 24 to 50 months), 54 patients (25%) died. CRP levels were similar between survivors and the deceased (median, 3.8 mg/L; 95% confidence interval, 1.9 to 8.1; vs median, 4.5 mg/L; 95% confidence interval, 2.1 to 11.5; p = 0.22) and was not significantly associated with survival. CONCLUSIONS: In this population of patients with clinically moderate to very severe COPD, the level of CRP level was not associated with survival compared with other prognostic clinical tools such as the BODE index, modified Medical Research Council scale, 6-min walk distance, percentage of predicted FEV(1), IC/TLC ratio < 0.25, and Pao(2). Other long-term studies of well-characterized patients with COPD could help determine the exact role of CRP levels as a biomarker in patients with clinical COPD.
BACKGROUND: Serum levels of C-reactive protein (CRP) are increased in patients with COPD and correlate modestly with variables predictive of outcomes. In epidemiologic studies, CRP level is associated with all-cause mortality in patients with mild-to-moderate disease. OBJECTIVE: To determine if CRP levels are associated with survival in patients with moderate to very severe COPD in comparison with other well-known prognostic parameters of the disease. METHODS: In 218 stable patients with COPD, we measured baseline serum CRP level, BODE (body mass index, obstruction, dyspnea, and exercise capacity) index and its components, arterial oxygenation (Pao(2)), inspiratory capacity (IC) to total lung capacity (TLC) ratio, and Charlson comorbidity score. We followed up the patients over time and evaluated the strength of the association between the variables and all-cause mortality. RESULTS: During the follow-up time (median, 36 months; 25th to 75th percentiles, 24 to 50 months), 54 patients (25%) died. CRP levels were similar between survivors and the deceased (median, 3.8 mg/L; 95% confidence interval, 1.9 to 8.1; vs median, 4.5 mg/L; 95% confidence interval, 2.1 to 11.5; p = 0.22) and was not significantly associated with survival. CONCLUSIONS: In this population of patients with clinically moderate to very severe COPD, the level of CRP level was not associated with survival compared with other prognostic clinical tools such as the BODE index, modified Medical Research Council scale, 6-min walk distance, percentage of predicted FEV(1), IC/TLC ratio < 0.25, and Pao(2). Other long-term studies of well-characterized patients with COPD could help determine the exact role of CRP levels as a biomarker in patients with clinical COPD.
Authors: James A Blumenthal; Patrick J Smith; Michael Durheim; Stephanie Mabe; Charles F Emery; Tereza Martinu; Philip T Diaz; Michael Babyak; Karen Welty-Wolf; Scott Palmer Journal: Psychosom Med Date: 2016 Feb-Mar Impact factor: 4.312
Authors: Yong Soo Kwon; Su Young Chi; Hong Joon Shin; Eun Young Kim; Byeong Kab Yoon; Hee Jung Ban; In Jae Oh; Kyu Sik Kim; Young Chul Kim; Sung Chul Lim Journal: J Korean Med Sci Date: 2010-09-17 Impact factor: 2.153