RT Journal Article SR Electronic T1 Inflammatory markers and COPD phenotypes as predictors of COPD exacerbations JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 4866 VO 42 IS Suppl 57 A1 Solveig Tangedal A1 Marianne Aanerud A1 Pål Aukrust A1 Gunnar Husebø A1 Jon Hardie A1 Louise Persson A1 Per Bakke A1 Tomas Eagan YR 2013 UL http://erj.ersjournals.com/content/42/Suppl_57/4866.abstract AB Background: COPD exacerbations accelerate disease progression.Aims: To examine if COPD phenotypes and systemic inflammatory markers predict the risk for COPD exacerbations, defined as requiring treatment with either systemic steroids or antibiotics.Methods: 433 COPD patients, GOLD stage II-IV, aged 40-76 yrs were included in the Bergen COPD Cohort Study in 2006/07, and followed for 3 years. Examined baseline predictors were sex, age, body composition, smoking habits, exacerbations the last year prior to baseline, GOLD stage, Charlson comorbidity score (CCS), presence of hypoxemia (PaO2<8 kPa), chronic cough, use of inhaled steroids and/or tiotropium, and the inflammatory markers C-reactive protein (CRP), neutrophil gelatinase associated lipocalin (NGAL), soluble tumor necrosis factor receptor 1 (sTNF-R1), and osteoprotegrin (OPG).Univariate and multivariable Poisson models with random effects were fitted to estimate the yearly incidence rate ratios (IRR).Results: Univariately, all variables except sex and CCS were significantly associated with the outcome. Higher levels of the inflammatory markers each predicted an increased yearly IRR (95% CI) per unit increase of the markers with IRR 1.03 (1.01-1.05), 1.07 (1.03-1.13), 1.06 (1.001-1.13), and 1.08 (1.01-1.16), respectively.Multivariately, significant predictors of COPD exacerbations were: age [IRR per 1 yr increase:1.02 (1.003-1.04)], female sex [1.35 (1.06-1.73)], >1 exacerbations last year before baseline [1,58 (1.17-2.13)], GOLD III [1.28 (1.01-1.64)], GOLD IV [2.73 (1.85-4.05)], chronic cough [1.61 (1.28-2.03)], use of inhaled steroids [1.67 (1.29-2.17)].Conclusion: Clinical COPD characteristics were independent predictors of exacerbations.