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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Vydané v:Thorax Ročník 74; číslo 5; s. 439 - 446
Hlavní autori: 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:English
Vydavateľské údaje: England BMJ Publishing Group Ltd and British Thoracic Society 01.05.2019
BMJ Publishing Group LTD
BMJ Publishing Group
Edícia:Original article
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ISSN:0040-6376, 1468-3296, 1468-3296
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Abstract 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.
AbstractList 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.
Conventional 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. To 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. We 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. Shorter 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. Findings 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. CRD42016052075.
Conventional 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.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.To 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.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.We 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.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.Shorter 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.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.Findings 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.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.CRD42016052075.TRIAL REGISTRATION NUMBERCRD42016052075.
Author Masconi, Katya L
Fermont, Jilles M
Jensen, Magnus T
Watz, Henrik
Schuetz, Philipp
Ferrari, Renata
Di Lorenzo, Valéria A P
Marott, Jacob M
Waschki, Benjamin
Wood, Angela M
Müllerova, Hana
Wilkinson, Ian B
Polkey, Michael I
AuthorAffiliation 10 Respiratory Muscle Laboratory, Royal Brompton Hospital , London , UK
7 Internal Medicine and Emergency Medicine, Kantonsspital Aarau , Univertsity of Basel , Aarau , Switzerland
3 Department of Cardiology , Copenhagen University Hospital Rigshospitalet , Copenhagen , Denmark
8 LungenClinic Grosshansorf, Airway Research Center North , German Center for Lung Research , Grosshansdorf , Germany
4 Copenhagen City Heart Study , Frederiksberg Hospital , Copenhagen , Denmark
2 Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care , University of Cambridge , Cambridge , UK
9 Worldwide Epidemiology, GlaxoSmithKline R&D , Uxbridge , UK
5 Division of Pulmonology, Department of Internal Medicine , Botucatu Medical School, Univ Estadual Paulista, UNESP , Botucatu , Brazil
6 Department of Physiotherapy , Federal University of Sao Carlos (UFSCar) , São Carlos/São Paulo , Brazil
1 Department of Medicine, Experimental Medicine and Immunotherapeutics , University of Cambridge , Cambrid
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  fullname: Jensen, Magnus T
  organization: Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark
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  givenname: Renata
  surname: Ferrari
  fullname: Ferrari, Renata
  organization: Division of Pulmonology, Department of Internal Medicine, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
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  fullname: Di Lorenzo, Valéria A P
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  orcidid: 0000-0002-1070-3661
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– sequence: 10
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  surname: Müllerova
  fullname: Müllerova, Hana
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– sequence: 11
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  surname: Polkey
  fullname: Polkey, Michael I
  organization: Respiratory Muscle Laboratory, Royal Brompton Hospital, London, UK
– sequence: 12
  givenname: Ian B
  surname: Wilkinson
  fullname: Wilkinson, Ian B
  organization: Department of Medicine, Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK
– sequence: 13
  givenname: Angela M
  surname: Wood
  fullname: Wood, Angela M
  organization: Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/30617161$$D View this record in MEDLINE/PubMed
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Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2019
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2024092104351367000_74.5.439.10
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2024092104351367000_74.5.439.49
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2024092104351367000_74.5.439.45
2024092104351367000_74.5.439.44
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2024092104351367000_74.5.439.70
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2024092104351367000_74.5.439.31
2024092104351367000_74.5.439.34
2024092104351367000_74.5.439.33
2024092104351367000_74.5.439.30
2024092104351367000_74.5.439.74
2024092104351367000_74.5.439.29
2024092104351367000_74.5.439.28
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2024092104351367000_74.5.439.69
2024092104351367000_74.5.439.24
2024092104351367000_74.5.439.68
2024092104351367000_74.5.439.27
Ferrari (2024092104351367000_74.5.439.41) 2011; 9
Marino (2024092104351367000_74.5.439.73) 2014; 18
2024092104351367000_74.5.439.26
2024092104351367000_74.5.439.4
2024092104351367000_74.5.439.3
Puhan (2024092104351367000_74.5.439.8) 2011; 10
2024092104351367000_74.5.439.2
2024092104351367000_74.5.439.1
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2024092104351367000_74.5.439.21
2024092104351367000_74.5.439.65
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2024092104351367000_74.5.439.64
2024092104351367000_74.5.439.23
Mannino (2024092104351367000_74.5.439.43) 2012; 9
2024092104351367000_74.5.439.67
2024092104351367000_74.5.439.22
2024092104351367000_74.5.439.66
2024092104351367000_74.5.439.9
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2024092104351367000_74.5.439.60
2024092104351367000_74.5.439.7
2024092104351367000_74.5.439.63
2024092104351367000_74.5.439.6
2024092104351367000_74.5.439.18
2024092104351367000_74.5.439.17
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2024092104351367000_74.5.439.19
2024092104351367000_74.5.439.14
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2024092104351367000_74.5.439.13
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Snippet BackgroundConventional measures to evaluate COPD may fail to capture systemic problems, particularly musculoskeletal weakness and cardiovascular disease....
Conventional measures to evaluate COPD may fail to capture systemic problems, particularly musculoskeletal weakness and cardiovascular disease. Identifying...
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StartPage 439
SubjectTerms 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
Title Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis
URI https://thorax.bmj.com/content/74/5/439.full
https://www.ncbi.nlm.nih.gov/pubmed/30617161
https://www.proquest.com/docview/2207786494
https://www.proquest.com/docview/2165058765
https://pubmed.ncbi.nlm.nih.gov/PMC6484697
Volume 74
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