Blood biomarkers as predictors of long-term mortality in COPD. Clin Respir J 2018 May;12(5):1891-1899
Date
12/12/2017Pubmed ID
29227024Pubmed Central ID
PMC5991987DOI
10.1111/crj.12752Scopus ID
2-s2.0-85045877534 (requires institutional sign-in at Scopus site) 45 CitationsAbstract
BACKGROUND: Blood biomarkers are easily accessible and might reflect chronic obstructive pulmonary disease (COPD) activity.
AIM: The aim of this study was to determine whether a panel of blood biomarkers [C-reactive protein (CRP), neutrophils, eosinophils, albumin and vitamin D] could predict mortality in COPD.
METHODS: We analyzed data from 431 COPD participants to the 2007-2010 National Health and Nutrition Examination Surveys who were followed for a median time of 36 months. COPD was defined as post-bronchodilator forced expiratory volume in 1 second (FEV1) and forced vital capacity ratio <0.70. Weibull survival analysis adjusted for covariates was performed to calculate the risk of mortality associated with the biomarkers, and C-statistics was used to assess their added predictive value.
RESULTS: During follow-up, 38 of the 431 participants died. Participants with high CRP, eosinophil count <2%, hypoalbuminemia and hypovitaminosis D had worse baseline FEV1 and subsequently higher mortality compared to controls. In adjusted analysis, increasing CRP [hazard ratio (HR): 4.45, 95% CI: 1.91-10.37] and neutrophil count (HR: 1.07, 95% CI: 1.03-1.11) as well as decreasing eosinophil count (HR: 7.03, 95% CI: 2.05-24.01) were associated with an increased risk of mortality. The addition of CRP with eosinophil and/or neutrophil count significantly improved a base model for the prediction of mortality which included age, gender, race/ethnicity, body mass index, smoking, poverty income ratio, asthma, diabetes, hypertension and history of stroke or myocardial infarction.
CONCLUSION: High CRP and neutrophils as well as low eosinophils are predictive of poor COPD prognosis. They also add significant value to prediction models of mortality in COPD.
Author List
Mendy A, Forno E, Niyonsenga T, Gasana JAuthor
Janvier Gasana MD, MPH, PhD Adjunct Associate Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Biomarkers
C-Reactive Protein
Cross-Sectional Studies
Eosinophils
Female
Forced Expiratory Volume
Humans
Male
Middle Aged
Neutrophils
Predictive Value of Tests
Prognosis
Pulmonary Disease, Chronic Obstructive
Respiratory Function Tests
Serum Albumin, Human
Vital Capacity
Vitamin D