PT  - JOURNAL ARTICLE
AU  - Solveig Tangedal
AU  - Marianne Aanerud
AU  - Pål Aukrust
AU  - Gunnar Husebø
AU  - Jon Hardie
AU  - Louise Persson
AU  - Per Bakke
AU  - Tomas Eagan
TI  - Inflammatory markers and COPD phenotypes as predictors of COPD exacerbations
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - 4866
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/4866.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/4866.full
SO  - Eur Respir J2013 Sep 01; 42
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.