Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort
Por:
Cosio, BG, Soriano, JB, Lopez-Campos, JL, Calle-Rubio, M, Soler-Cataluna, JJ, de-Torres, JP, Marin, JM, Martinez-Gonzalez, C, de Lucas, P, Mir, I, Peces-Barba, G, Feu-Collado, N, Solanes, I, Alfageme, I, Casanova, C
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:
Hosp Son Espases IdISPa, Dept Resp Med, Palma De Mallorca, Mallorca, Spain
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain
Soriano, JB:
Univ Autonoma Madrid, Inst Invest Hosp Univ la Princesa IISP, Catedra UAM Linde, Madrid, Spain
Lopez-Campos, JL:
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain
Hosp Univ Virgen del Rocio IBiS, Dept Resp Med, Seville, Spain
Calle-Rubio, M:
Hosp Clin San Carlos, Dept Resp Med, Madrid, Spain
Soler-Cataluna, JJ:
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain
Hosp Arnau Vilanova, Dept Resp Med, Valencia, Spain
de-Torres, JP:
Univ Navarra Clin, Dept Resp Med, Pamplona, Spain
Marin, JM:
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain
Hosp Univ Miguel Servet, Dept Resp Med, Zaragoza, Spain
Martinez-Gonzalez, C:
Hosp Cent Asturias, Dept Resp Med, Oviedo, Spain
de Lucas, P:
Hosp Gen Gregorio Maranon, Dept Resp Med, Madrid, Spain
Mir, I:
Hosp Son Llatzer, Dept Resp Med, Palma De Mallorca, Spain
Peces-Barba, G:
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain
Fdn Jimenez Diaz, Dept Resp Med, E-28040 Madrid, Spain
Feu-Collado, N:
Cordoba IMIBIC UCO, Hosp Univ Reina Sofia, Dept Resp Med, Cordoba, Spain
Solanes, I:
Hosp San Pablo & Santa Cruz, Dept Resp Med, Barcelona, Spain
Alfageme, I:
Hosp Univ deValme, Dept Resp Med, Seville, Spain
Casanova, C:
Hosp Ntra Sra Candelaria, Dept Resp Med, Tenerife, Spain
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