Tomás Posadas1, Grace Oscullo1, Enrique Zaldivar1, Carmen Villa2, Yadira Dobarganes2, Rosa Girón3, Casilda Olveira4, Luis Maíz5, Marta García-Clemente6, Oriol Sibila7, Rafael Golpe8, Juan Rodríguez9, Esther Barreiro10, Juan Luis Rodriguez11, Rosario Menéndez1, Concepción Prados12, David de la Rosa12, Miguel Angel Martinez-García13. 1. Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain. 2. Respiratory Department, Clinica Fuensanta, Madrid, Spain. 3. Instituto de Investigación Sanitaria, Respiratory Department, Hospital Universitario de la Princesa, Madrid, Spain. 4. Pneumology Department, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA)/Universidad de Málaga, Málaga, Spain. 5. Respiratory Department, Hospital Ramon and Cajal, Madrid, Spain. 6. Respiratory Department, Hospital Universitario Central de Asturias, Oviedo, Spain. 7. Pneumology Department, Hospital Clínic Barcelona, Spain. 8. Respiratory Department, Hospital Lucus Augusti, Lugo, Spain. 9. Respiratory Department, Hospital San Agustin, Avilés, Spain. 10. Respiratory Department, Hospital del Mar-IMIM, UPF, CIBERES, Spain. 11. Respiratory Department, Hospital San Carlos, Madrid, Spain. 12. Respiratory Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain. 13. Respiratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain. Electronic address: mianmartinezgarcia@gmail.com.
Abstract
BACKGROUND: Both systemic inflammation and exacerbations have been associated with greater severity of bronchiectasis. Our objective was to analyze the prognostic value of the peripheral concentration of C-reactive protein (CRP) for the number and severity of exacerbations in patients with bronchiectasis. METHODS: Patients from the Spanish Bronchiectasis Registry (RIBRON) with valid data on their CRP value (in a clinically stable phase) and valid data on exacerbations during the first year of follow-up were included. A logistic regression analysis was used to evaluate the prognostic value of the CRP concentration (divided into tertiles) with the presence of at least one severe exacerbation or at least two mild-moderate exacerbations during the first year of follow-up. RESULTS: 802 patients (mean age: 68.1 [11.1 years], 65% female) were included. Of these, 33.8% and 13%, respectively, presented ≥2 mild-moderate exacerbations or at least one severe exacerbation during the first year of follow-up. The mean value of the CRP was 6.5 (17.6mg/L). Patients with a CRP value between 0.4 and 2.7mg/L (second tertile) and ≥2.7mg/L (third tertile) presented a 2.9 (95%CI: 1.4-5.9) and 4.2 (95%CI: 2.2-8.2) times greater probability, respectively, of experiencing a severe exacerbation than those with <0.4mg/L (control group), regardless of bronchiectasis severity or a history of previous exacerbations. However, the CRP value did not present any prognostic value for the number of mild-moderate exacerbations. CONCLUSIONS: The CRP value was associated with a greater risk of future severe exacerbations but not with mild or moderate exacerbations in patients with steady-state bronchiectasis.
BACKGROUND: Both systemic inflammation and exacerbations have been associated with greater severity of bronchiectasis. Our objective was to analyze the prognostic value of the peripheral concentration of C-reactive protein (CRP) for the number and severity of exacerbations in patients with bronchiectasis. METHODS:Patients from the Spanish Bronchiectasis Registry (RIBRON) with valid data on their CRP value (in a clinically stable phase) and valid data on exacerbations during the first year of follow-up were included. A logistic regression analysis was used to evaluate the prognostic value of the CRP concentration (divided into tertiles) with the presence of at least one severe exacerbation or at least two mild-moderate exacerbations during the first year of follow-up. RESULTS: 802 patients (mean age: 68.1 [11.1 years], 65% female) were included. Of these, 33.8% and 13%, respectively, presented ≥2 mild-moderate exacerbations or at least one severe exacerbation during the first year of follow-up. The mean value of the CRP was 6.5 (17.6mg/L). Patients with a CRP value between 0.4 and 2.7mg/L (second tertile) and ≥2.7mg/L (third tertile) presented a 2.9 (95%CI: 1.4-5.9) and 4.2 (95%CI: 2.2-8.2) times greater probability, respectively, of experiencing a severe exacerbation than those with <0.4mg/L (control group), regardless of bronchiectasis severity or a history of previous exacerbations. However, the CRP value did not present any prognostic value for the number of mild-moderate exacerbations. CONCLUSIONS: The CRP value was associated with a greater risk of future severe exacerbations but not with mild or moderate exacerbations in patients with steady-state bronchiectasis.
Authors: Joshua P Metlay; Grant W Waterer; Ann C Long; Antonio Anzueto; Jan Brozek; Kristina Crothers; Laura A Cooley; Nathan C Dean; Michael J Fine; Scott A Flanders; Marie R Griffin; Mark L Metersky; Daniel M Musher; Marcos I Restrepo; Cynthia G Whitney Journal: Am J Respir Crit Care Med Date: 2019-10-01 Impact factor: 21.405
Authors: Xuejie Wang; Casilda Olveira; Rosa Girón; Marta García-Clemente; Luis Máiz; Oriol Sibila; Rafael Golpe; Rosario Menéndez; Juan Rodríguez-López; Concepción Prados; Miguel Angel Martinez-García; Juan Luis Rodriguez; David de la Rosa; Liyun Qin; Xavier Duran; Jordi Garcia-Ojalvo; Esther Barreiro Journal: Biomedicines Date: 2022-04-30
Authors: Xuejie Wang; Carmen Villa; Yadira Dobarganes; Casilda Olveira; Rosa Girón; Marta García-Clemente; Luis Máiz; Oriol Sibila; Rafael Golpe; Rosario Menéndez; Juan Rodríguez-López; Concepción Prados; Miguel Angel Martinez-García; Juan Luis Rodriguez; David de la Rosa; Xavier Duran; Jordi Garcia-Ojalvo; Esther Barreiro Journal: Biomedicines Date: 2022-01-21
Authors: Marta García Clemente; Casilda Olveira; Rosa Girón; Luis Máiz; Oriol Sibila; Rafael Golpe; Rosario Menéndez; Juan Rodríguez; Esther Barreiro; Juan Luis Rodríguez Hermosa; Concepción Prados; David De la Rosa; Claudia Madrid Carbajal; Marta Solís; Miguel Ángel Martínez-García Journal: J Clin Med Date: 2022-07-07 Impact factor: 4.964