C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease

Morten Dahl; Jørgen Vestbo; Peter Lange; Stig E Bojesen; Anne Tybjaerg-Hansen; Børge G Nordestgaard

doi:10.1164/rccm.200605-713OC

C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease

Morten Dahl, Jørgen Vestbo, Peter Lange, Stig E Bojesen, Anne Tybjaerg-Hansen, Børge G Nordestgaard

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422 Citationer (Scopus)

Abstract

RATIONALE: Patients with chronic obstructive pulmonary disease (COPD) have an ongoing systemic inflammation, which can be assessed by measuring serum C-reactive protein (CRP). OBJECTIVE: To determine whether increased serum CRP in individuals with airway obstruction predicts future hospitalization and death from COPD. METHODS: We performed a cohort study with a median of 8-yr follow-up of 1,302 individuals with airway obstruction selected from the ongoing Copenhagen City Heart Study. MEASUREMENTS AND MAIN RESULTS: We measured serum CRP at baseline, and recorded COPD admissions and deaths as outcomes. During follow-up, 185 (14%) individuals were hospitalized due to COPD and 83 (6%) died of COPD. Incidences of COPD hospitalization and COPD death were increased in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L (log rank: p < 0.001). After adjusting for sex, age, FEV(1)% predicted, tobacco consumption, and ischemic heart disease, the hazard ratios for hospitalization and death due to COPD were increased at 1.4 (95% confidence interval, 1.0-2.0) and 2.2 (1.2-3.9) in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L. After close matching for FEV(1)% predicted and adjusting for potential confounders, baseline CRP was, on average, increased by 1.2 mg/L (analysis of variance: p = 0.002) and 4.1 mg/L (p = 0.001) in those who were subsequently hospitalized or died of COPD, respectively. The absolute 10-yr risks for COPD hospitalization and death in individuals with CRP above 3 mg/L were 54 and 57%, respectively, among those older than 70 yr with a tobacco consumption above 15 g/d and an FEV(1)% predicted of less than 50. CONCLUSIONS: CRP is a strong and independent predictor of future COPD outcomes in individuals with airway obstruction.
Udgivelsesdato: Feb 1

Originalsprog	Engelsk
Tidsskrift	American Journal of Respiratory and Critical Care Medicine
Vol/bind	175
Udgave nummer	3
Sider (fra-til)	250-5
Antal sider	6
ISSN	1073-449X
DOI	https://doi.org/10.1164/rccm.200605-713OC
Status	Udgivet - 2007

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10.1164/rccm.200605-713OC

http://ajrccm.atsjournals.org/cgi/content/full/175/3/250

Citationsformater

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title = "C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease",

abstract = "RATIONALE: Patients with chronic obstructive pulmonary disease (COPD) have an ongoing systemic inflammation, which can be assessed by measuring serum C-reactive protein (CRP). OBJECTIVE: To determine whether increased serum CRP in individuals with airway obstruction predicts future hospitalization and death from COPD. METHODS: We performed a cohort study with a median of 8-yr follow-up of 1,302 individuals with airway obstruction selected from the ongoing Copenhagen City Heart Study. MEASUREMENTS AND MAIN RESULTS: We measured serum CRP at baseline, and recorded COPD admissions and deaths as outcomes. During follow-up, 185 (14%) individuals were hospitalized due to COPD and 83 (6%) died of COPD. Incidences of COPD hospitalization and COPD death were increased in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L (log rank: p < 0.001). After adjusting for sex, age, FEV(1)% predicted, tobacco consumption, and ischemic heart disease, the hazard ratios for hospitalization and death due to COPD were increased at 1.4 (95% confidence interval, 1.0-2.0) and 2.2 (1.2-3.9) in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L. After close matching for FEV(1)% predicted and adjusting for potential confounders, baseline CRP was, on average, increased by 1.2 mg/L (analysis of variance: p = 0.002) and 4.1 mg/L (p = 0.001) in those who were subsequently hospitalized or died of COPD, respectively. The absolute 10-yr risks for COPD hospitalization and death in individuals with CRP above 3 mg/L were 54 and 57%, respectively, among those older than 70 yr with a tobacco consumption above 15 g/d and an FEV(1)% predicted of less than 50. CONCLUSIONS: CRP is a strong and independent predictor of future COPD outcomes in individuals with airway obstruction.",

keywords = "Aged, Biological Markers, C-Reactive Protein, Cohort Studies, Female, Hospitalization, Humans, Male, Middle Aged, Outcome Assessment (Health Care), Prognosis, Pulmonary Disease, Chronic Obstructive, Risk",

author = "Morten Dahl and J{\o}rgen Vestbo and Peter Lange and Bojesen, {Stig E} and Anne Tybjaerg-Hansen and Nordestgaard, {B{\o}rge G}",

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doi = "10.1164/rccm.200605-713OC",

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pages = "250--5",

journal = "American Journal of Respiratory and Critical Care Medicine",

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TY - JOUR

T1 - C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease

AU - Dahl, Morten

AU - Vestbo, Jørgen

AU - Lange, Peter

AU - Bojesen, Stig E

AU - Tybjaerg-Hansen, Anne

AU - Nordestgaard, Børge G

PY - 2007

Y1 - 2007

N2 - RATIONALE: Patients with chronic obstructive pulmonary disease (COPD) have an ongoing systemic inflammation, which can be assessed by measuring serum C-reactive protein (CRP). OBJECTIVE: To determine whether increased serum CRP in individuals with airway obstruction predicts future hospitalization and death from COPD. METHODS: We performed a cohort study with a median of 8-yr follow-up of 1,302 individuals with airway obstruction selected from the ongoing Copenhagen City Heart Study. MEASUREMENTS AND MAIN RESULTS: We measured serum CRP at baseline, and recorded COPD admissions and deaths as outcomes. During follow-up, 185 (14%) individuals were hospitalized due to COPD and 83 (6%) died of COPD. Incidences of COPD hospitalization and COPD death were increased in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L (log rank: p < 0.001). After adjusting for sex, age, FEV(1)% predicted, tobacco consumption, and ischemic heart disease, the hazard ratios for hospitalization and death due to COPD were increased at 1.4 (95% confidence interval, 1.0-2.0) and 2.2 (1.2-3.9) in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L. After close matching for FEV(1)% predicted and adjusting for potential confounders, baseline CRP was, on average, increased by 1.2 mg/L (analysis of variance: p = 0.002) and 4.1 mg/L (p = 0.001) in those who were subsequently hospitalized or died of COPD, respectively. The absolute 10-yr risks for COPD hospitalization and death in individuals with CRP above 3 mg/L were 54 and 57%, respectively, among those older than 70 yr with a tobacco consumption above 15 g/d and an FEV(1)% predicted of less than 50. CONCLUSIONS: CRP is a strong and independent predictor of future COPD outcomes in individuals with airway obstruction.

AB - RATIONALE: Patients with chronic obstructive pulmonary disease (COPD) have an ongoing systemic inflammation, which can be assessed by measuring serum C-reactive protein (CRP). OBJECTIVE: To determine whether increased serum CRP in individuals with airway obstruction predicts future hospitalization and death from COPD. METHODS: We performed a cohort study with a median of 8-yr follow-up of 1,302 individuals with airway obstruction selected from the ongoing Copenhagen City Heart Study. MEASUREMENTS AND MAIN RESULTS: We measured serum CRP at baseline, and recorded COPD admissions and deaths as outcomes. During follow-up, 185 (14%) individuals were hospitalized due to COPD and 83 (6%) died of COPD. Incidences of COPD hospitalization and COPD death were increased in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L (log rank: p < 0.001). After adjusting for sex, age, FEV(1)% predicted, tobacco consumption, and ischemic heart disease, the hazard ratios for hospitalization and death due to COPD were increased at 1.4 (95% confidence interval, 1.0-2.0) and 2.2 (1.2-3.9) in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L. After close matching for FEV(1)% predicted and adjusting for potential confounders, baseline CRP was, on average, increased by 1.2 mg/L (analysis of variance: p = 0.002) and 4.1 mg/L (p = 0.001) in those who were subsequently hospitalized or died of COPD, respectively. The absolute 10-yr risks for COPD hospitalization and death in individuals with CRP above 3 mg/L were 54 and 57%, respectively, among those older than 70 yr with a tobacco consumption above 15 g/d and an FEV(1)% predicted of less than 50. CONCLUSIONS: CRP is a strong and independent predictor of future COPD outcomes in individuals with airway obstruction.

KW - Aged

KW - Biological Markers

KW - C-Reactive Protein

KW - Cohort Studies

KW - Female

KW - Hospitalization

KW - Humans

KW - Male

KW - Middle Aged

KW - Outcome Assessment (Health Care)

KW - Prognosis

KW - Pulmonary Disease, Chronic Obstructive

KW - Risk

U2 - 10.1164/rccm.200605-713OC

DO - 10.1164/rccm.200605-713OC

M3 - Journal article

C2 - 17053205

SN - 1073-449X

VL - 175

SP - 250

EP - 255

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

IS - 3

ER -

C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease

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