RT Journal Article
SR Electronic
T1 Persistently elevated exhaled nitric oxide fraction is associated with increased risk of exacerbation in COPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1701457
DO 10.1183/13993003.01457-2017
VO 51
IS 1
A1 Bernardino Alcázar-Navarrete
A1 Oliverio Ruiz Rodríguez
A1 Pablo Conde Baena
A1 Pedro José Romero Palacios
A1 Alvar Agusti
YR 2018
UL http://erj.ersjournals.com/content/51/1/1701457.abstract
AB Preventing the occurrence of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is a major therapeutic goal. We hypothesise that persistently increased levels of exhaled nitric oxide (FeNO) during follow-up can identify a group of COPD patients at higher risk of AECOPD.To test this hypothesis, we measured FeNO levels (HypAir FeNO®, Medisoft; Sorinnes, Belgium) prospectively in 226 clinically stable COPD outpatients at recruitment and during follow-up (at 6 and 12 months). Patients were stratified according to the number of visits with FeNO ≥20 ppb.FeNO was <20 ppb in all three visits in 44.2% of patients, 29.6% in visit 1 and 26.1% in visit 2 or 3. These three groups suffered progressively higher AECOPD rates during follow-up (0.67, 0.91 and 1.42, respectively, p<0.001). After adjusting for potential confounding variables (log-rank test), the hazard ratio for AECOPD was higher in the latter group (1.579 (95% CI 1.049–2.378), p=0.029). Likewise, time to first moderate and severe AECOPD was shorter in these patients. Finally, there was no relationship between FeNO levels and circulating eosinophils.Persistent FeNO levels ≥20 ppb in clinically stable COPD outpatients are associated with a significantly higher risk of AECOPD.Persistently elevated FeNO levels in COPD are associated with a higher risk of exacerbation http://ow.ly/fdPy30hdBzo