Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort
Por:
Cosio BG, Soriano JB, López-Campos JL, Calle-Rubio M, Soler-Cataluna JJ, de-Torres JP, Marín JM, Martínez-Gonzalez C, de Lucas P, Mir I, Peces-Barba G, Feu-Collado N, Solanes I, Alfageme I, Casanova C and CHAIN Study
Publicada:
1 ene 2016
Resumen:
BACKGROUND: Asthma-COPD overlap syndrome (ACOS) has been recently described by international guidelines. A stepwise approach to diagnosis using usual features of both diseases is recommended although its clinical application is difficult.
METHODS: To identify patients with ACOS, a cohort of well-characterized patients with COPD and up to 1 year of follow-up was analyzed. We evaluated the presence of specific characteristics associated with asthma in this COPD cohort, divided into major criteria (bronchodilator test > 400 mL and 15% and past medical history of asthma) and minor criteria (blood eosinophils > 5%, IgE > 100 IU/mL, or two separate bronchodilator tests > 200 mL and 12%). We defined ACOS by the presence of one major criterion or two minor criteria. Baseline characteristics, health status (COPD Assessment Test [CAT]), BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index, rate of exacerbations, and mortality up to 1 year of follow-up were compared between patients with and without criteria for ACOS.
RESULTS: Of 831 patients with COPD included, 125 (15%) fulfilled the criteria for ACOS, and 98.4% of them sustained these criteria after 1 year. Patients with ACOS were predominantly male (81.6%), with symptomatic mild to moderate disease (67%), who were receiving inhaled corticosteroids (63.2%). There were no significant differences in baseline characteristics, and only survival was worse in patients with non-ACOS COPD after 1 year of follow-up (P <.05).
CONCLUSIONS: The proposed ACOS criteria are present in 15% of a cohort of patients with COPD and these patients show better 1-year prognosis than clinically similar patients with COPD with no ACOS criteria.
Filiaciones:
Cosio BG:
Department of Respiratory Medicine, Hospital Son Espases-IdISPa, Palma de Mallorca, Mallorca, Spain
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
Soriano JB:
Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid (UAM), Cátedra UAM-Linde, Madrid, Spain
López-Campos JL:
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
Department of Respiratory Medicine, Hospital Universitario Virgen del Rocío-IBiS, Sevilla, Spain
Calle-Rubio M:
Department of Respiratory Medicine, Hospital Clinico San Carlos, Madrid, Spain
:
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
Department of Respiratory Medicine, Hospital Arnau de Vilanova, Valencia, Spain
de-Torres JP:
Department of Respiratory Medicine, Clínica Universidad de Navarra, Pamplona, Spain
Marín JM:
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
Department of Respiratory Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
Martínez-Gonzalez C:
Department of Respiratory Medicine, Hospital Central de Asturias, Oviedo, Spain
de Lucas P:
Department of Respiratory Medicine, Hospital Gregorio Marañon, Madrid, Spain
Mir I:
Department of Respiratory Medicine, Hospital Son Llátzer, Palma de Mallorca, Spain
Peces-Barba G:
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
Department of Respiratory Medicine, Fundación Jimenez Diaz, Madrid, Spain
Feu-Collado N:
Department of Respiratory Medicine, Hospital Universitario Reina Sofía, Cordoba-IMIBIC.UCO, Spain
Solanes I:
Department of Respiratory Medicine, Hospital San Pablo y la Santa Cruz, Barcelona, Spain
Alfageme I:
Department of Respiratory Medicine, Hospital Universitario deValme, Sevilla, Spain
Casanova C:
Department of Respiratory Medicine, Hospital Ntra. Sra. de Candelaria, Tenerife, Spain
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