Comorbidity, systemic inflammation and outcomes in the ECLIPSE cohort

Joy Miller, Lisa D. Edwards, Alvar Agustí, Per Bakke, Peter M.A. Calverley, Bartolome Celli, Harvey O. Coxson, Courtney Crim, David A. Lomas, Bruce E. Miller, Steve Rennard, Edwin K. Silverman, Ruth Tal-Singer, Jørgen Vestbo, Emiel Wouters, Julie C. Yates, William Macnee

Research output: Contribution to journalArticle

187 Scopus citations

Abstract

Comorbidities, are common in COPD, have been associated with poor outcomes and are thought to relate to systemic inflammation. To investigate comorbidities in relation to systemic inflammation and outcomes we recorded comorbidities in a well characterized cohort (ECLIPSE study) for 2164 clinically stable COPD subjects, 337 smokers and 245 non-smokers with normal lung function. COPD patients had a higher prevalence of osteoporosis, anxiety/panic attacks, heart trouble, heart attack, and heart failure, than smokers or nonsmokers. Heart failure (Hazard Ratio [HR] 1.9, 95% Confidence Interval [CI] 1.3-2.9), ischemic heart disease (HR 1.5, 95% CI 1.1-2.0), heart disease (HR 1.5, 95% CI 1.2-2.0), and diabetes (HR 1.7, 95% CI 1.2-2.4) had increased odds of mortality when coexistent with COPD. Multiple comorbidities had accumulative effect on mortality. COPD and cardiovascular disease was associated with poorer quality of life, higher MRC dyspnea scores, reduced 6MWD, higher BODE index scores. Osteoporosis, hypertension and diabetes were associated with higher MRC dyspnea scores and reduced 6MWD. Higher blood concentrations of fibrinogen, IL-6 and IL-8 levels occurred in those with heart disease. Comorbidity is associated with poor clinical outcomes in COPD. The comorbidities of heart disease, hypertension and diabetes are associated with increased systemic inflammation.

Original languageEnglish (US)
Pages (from-to)1376-1384
Number of pages9
JournalRespiratory Medicine
Volume107
Issue number9
DOIs
StatePublished - Sep 2013

Keywords

  • Cardiovascular disease
  • Chronic obstructive pulmonary disease
  • Cigarette smoking
  • Diabetes
  • Emphysema
  • Osteoporosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Miller, J., Edwards, L. D., Agustí, A., Bakke, P., Calverley, P. M. A., Celli, B., Coxson, H. O., Crim, C., Lomas, D. A., Miller, B. E., Rennard, S., Silverman, E. K., Tal-Singer, R., Vestbo, J., Wouters, E., Yates, J. C., & Macnee, W. (2013). Comorbidity, systemic inflammation and outcomes in the ECLIPSE cohort. Respiratory Medicine, 107(9), 1376-1384. https://doi.org/10.1016/j.rmed.2013.05.001