RT Journal Article
SR Electronic
T1 Inflammatory biomarkers and comorbidities in chronic obstructive pulmonary disease
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P455
VO 40
IS Suppl 56
A1 Thomsen, Mette
A1 Dahl, Morten
A1 Lange, Peter
A1 Vestbo, Jørgen
A1 Nordestgaard, Børge
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P455.abstract
AB BackgroundPatients with chronic obstructive pulmonary disease (COPD) have evidence of systemic inflammation that may be implicated in the development of comorbidities. We tested the hypothesis that elevated levels of three inflammatory biomarkers are associated with increased risk of comorbidities in COPD.MethodsWe measured baseline C-reactive protein (CRP), fibrinogen, and leukocyte count in 10,052 COPD patients from two large population studies. During a median 5-years follow-up we recorded hospital admissions due to ischemic heart disease, myocardial infarction, heart failure, type II diabetes, lung cancer, pneumonia, pulmonary embolism, hip fracture, and depression as endpoints.ResultsMultifactorially adjusted risk of ischemic heart disease was increased by a factor of 2.19 (95% confidence interval 1.48 to 3.23) in individuals with three biomarkers elevated (CRP above 3 mg per liter, fibrinogen above 14 μmol per liter, and leukocyte count above 9 x109 per liter) versus individuals with all three biomarkers at or below these limits. Corresponding hazard ratios were 2.32 (1.34 to 4.04) for myocardial infarction, 2.63 (1.71 to 4.04) for heart failure, 3.54 (2.03 to 6.19) for diabetes, 4.00 (2.12 to 7.54) for lung cancer, and 2.71 (2.03 to 3.63) for pneumonia. There were no consistent differences in risk of pulmonary embolism, hip fracture, or depression as a function of these three biomarkers.ConclusionsSimultaneously elevated levels of CRP, fibrinogen, and leukocyte count are associated with a 2 to 4-fold increased risk of major comorbidities in COPD. These findings may enable clinicians to conduct stratified management of comorbidities in COPD patients.