RT Journal Article
SR Electronic
T1 COPD prognosis in relation to diagnostic criteria for airflow obstruction in smokers
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 54
OP 63
DO 10.1183/09031936.00158212
VO 43
IS 1
A1 Reinier P. Akkermans
A1 Marion Biermans
A1 Bas Robberts
A1 Gerben ter Riet
A1 Annelies Jacobs
A1 Chris van Weel
A1 Michel Wensing
A1 Tjard Schermer
YR 2014
UL http://erj.ersjournals.com/content/43/1/54.abstract
AB The aim of this study was to establish which cut-off point for the forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio (i.e. fixed 0.70 or lower limit of normal (LLN) cut-off point) best predicts accelerated lung function decline and exacerbations in middle-aged smokers. We performed secondary analyses on the Lung Health Study dataset. 4045 smokers aged 35–60 years with mild-to-moderate obstructive pulmonary disease were subdivided into categories based on presence or absence of obstruction according to both FEV1/FVC cut-off points. Post-bronchodilator FEV1 decline served as the primary outcome to compare subjects between the categories. 583 (14.4%) subjects were nonobstructed and 3230 (79.8%) subjects were obstructed according to both FEV1/FVC cut-off points. 173 (4.3%) subjects were obstructed according to the fixed cut-off point, but not according to the LLN cut-off point (“discordant” subjects). Mean±se post-bronchodilator FEV1 decline was 41.8±2.0 mL·year−1 in nonobstructed subjects, 43.8±3.8 mL·year−1 in discordant subjects and 53.5±0.9 mL·year−1 in obstructed subjects (p<0.001). Our study showed that FEV1 decline in subjects deemed obstructed according to a fixed criterion (FEV1/FVC <0.70), but non-obstructed by a sex- and age-specific criterion (LLN) closely resembles FEV1 decline in subjects designated as non-obstructed by both criteria. Sex and age should be taken into account when assessing airflow obstruction in middle-aged smokers. Lower limit of normal cut-off best predicts accelerated lung function decline and exacerbation in middle-aged smokers http://ow.ly/qaZnz