Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis

BackgroundConventional measures to evaluate COPD may fail to capture systemic problems, particularly musculoskeletal weakness and cardiovascular disease. Identifying these manifestations and assessing their association with clinical outcomes (ie, mortality, exacerbation and COPD hospital admission)...

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Vydáno v:Thorax Ročník 74; číslo 5; s. 439 - 446
Hlavní autoři: Fermont, Jilles M, Masconi, Katya L, Jensen, Magnus T, Ferrari, Renata, Di Lorenzo, Valéria A P, Marott, Jacob M, Schuetz, Philipp, Watz, Henrik, Waschki, Benjamin, Müllerova, Hana, Polkey, Michael I, Wilkinson, Ian B, Wood, Angela M
Médium: Journal Article
Jazyk:angličtina
Vydáno: England BMJ Publishing Group Ltd and British Thoracic Society 01.05.2019
BMJ Publishing Group LTD
BMJ Publishing Group
Edice:Original article
Témata:
Biomarkers - metabolism
Chronic Obstructive Pulmonary Disease
Clinical outcomes
copd epidemiology
Exercise Test
Hemodynamics - physiology
Humans
Meta-analysis
Mortality
Pulmonary Disease, Chronic Obstructive - diagnosis
Pulmonary Disease, Chronic Obstructive - metabolism
Pulmonary Disease, Chronic Obstructive - physiopathology
Respiratory Function Tests
Severity of Illness Index
Studies
Systematic review
Tumor necrosis factor-TNF
copd epidemiology
ISSN:0040-6376, 1468-3296, 1468-3296
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Shrnutí:BackgroundConventional measures to evaluate COPD may fail to capture systemic problems, particularly musculoskeletal weakness and cardiovascular disease. Identifying these manifestations and assessing their association with clinical outcomes (ie, mortality, exacerbation and COPD hospital admission) is of increasing clinical importance.ObjectiveTo assess associations between 6 min walk distance (6MWD), heart rate, fibrinogen, C reactive protein (CRP), white cell count (WCC), interleukins 6 and 8 (IL-6 and IL-8), tumour necrosis factor-alpha, quadriceps maximum voluntary contraction, sniff nasal inspiratory pressure, short physical performance battery, pulse wave velocity, carotid intima-media thickness and augmentation index and clinical outcomes in patients with stable COPD.MethodsWe systematically searched electronic databases (August 2018) and identified 61 studies, which were synthesised, including meta-analyses to estimate pooled HRs, following Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsShorter 6MWD and elevated heart rate, fibrinogen, CRP and WCC were associated with higher risk of mortality. Pooled HRs were 0.80 (95% CI 0.73 to 0.89) per 50 m longer 6MWD, 1.10 (95% CI 1.02 to 1.18) per 10 bpm higher heart rate, 3.13 (95% CI 2.14 to 4.57) per twofold increase in fibrinogen, 1.17 (95% CI 1.06 to 1.28) per twofold increase in CRP and 2.07 (95% CI 1.29 to 3.31) per twofold increase in WCC. Shorter 6MWD and elevated fibrinogen and CRP were associated with exacerbation, and shorter 6MWD, higher heart rate, CRP and IL-6 were associated with hospitalisation. Few studies examined associations with musculoskeletal measures.ConclusionFindings suggest 6MWD, heart rate, CRP, fibrinogen and WCC are associated with clinical outcomes in patients with stable COPD. Use of musculoskeletal measures to assess outcomes in patients with COPD requires further investigation.Trial registration numberCRD42016052075.
Bibliografie:Original article
ObjectType-Article-1
ObjectType-Evidence Based Healthcare-3
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ObjectType-Undefined-3
ISSN:0040-6376
1468-3296
1468-3296
DOI:10.1136/thoraxjnl-2018-211855