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

164 Citations (Scopus)

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 1 2013

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Chronic Obstructive Pulmonary Disease
Comorbidity
Inflammation
Confidence Intervals
Heart Diseases
Dyspnea
Osteoporosis
Heart Failure
Hypertension
Mortality
Panic Disorder
Interleukin-8
Fibrinogen
Myocardial Ischemia
Interleukin-6
Cohort Studies
Cardiovascular Diseases
Anxiety
Myocardial Infarction
Quality of Life

Keywords

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

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Miller, J., Edwards, L. D., Agustí, A., Bakke, P., Calverley, P. M. A., Celli, B., ... 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

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

In: Respiratory Medicine, Vol. 107, No. 9, 01.09.2013, p. 1376-1384.

Research output: Contribution to journalArticle

Miller, J, Edwards, LD, Agustí, A, Bakke, P, Calverley, PMA, Celli, B, Coxson, HO, Crim, C, Lomas, DA, Miller, BE, Rennard, S, Silverman, EK, Tal-Singer, R, Vestbo, J, Wouters, E, Yates, JC & Macnee, W 2013, 'Comorbidity, systemic inflammation and outcomes in the ECLIPSE cohort', Respiratory Medicine, vol. 107, no. 9, pp. 1376-1384. https://doi.org/10.1016/j.rmed.2013.05.001
Miller J, Edwards LD, Agustí A, Bakke P, Calverley PMA, Celli B et al. Comorbidity, systemic inflammation and outcomes in the ECLIPSE cohort. Respiratory Medicine. 2013 Sep 1;107(9):1376-1384. https://doi.org/10.1016/j.rmed.2013.05.001
Miller, Joy ; Edwards, Lisa D. ; Agustí, Alvar ; Bakke, Per ; Calverley, Peter M.A. ; Celli, Bartolome ; Coxson, Harvey O. ; Crim, Courtney ; Lomas, David A. ; Miller, Bruce E. ; Rennard, Steve ; Silverman, Edwin K. ; Tal-Singer, Ruth ; Vestbo, Jørgen ; Wouters, Emiel ; Yates, Julie C. ; Macnee, William. / Comorbidity, systemic inflammation and outcomes in the ECLIPSE cohort. In: Respiratory Medicine. 2013 ; Vol. 107, No. 9. pp. 1376-1384.
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