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Measures of low lung function and the prediction of incident COPD events and acute coronary events

Zaigham, Suneela LU ; Johnson, Linda LU ; Wollmer, Per LU and Engström, Gunnar LU (2018) In Respiratory Medicine 144. p.68-73
Abstract

Background: Although reduced lung function is associated with both COPD and coronary events (CE), the pattern of lung function impairment could be different for the two outcomes. We examined different measures of lung function in relation to incident COPD events and CE in a population-based cohort. Methods: Baseline spirometry and lung clearance index (LCI) were assessed in 672 men aged 55 years. Outcomes included incident COPD events and CE (hospitalisation or mortality). Cox regression was used to obtain HRs per 1-standard deviation (SD) decrement in baseline lung function. The Lunn-McNeil competing risks approach was used to assess if differences in risks for incident COPD events and CE were significant. Results: Over 44 years... (More)

Background: Although reduced lung function is associated with both COPD and coronary events (CE), the pattern of lung function impairment could be different for the two outcomes. We examined different measures of lung function in relation to incident COPD events and CE in a population-based cohort. Methods: Baseline spirometry and lung clearance index (LCI) were assessed in 672 men aged 55 years. Outcomes included incident COPD events and CE (hospitalisation or mortality). Cox regression was used to obtain HRs per 1-standard deviation (SD) decrement in baseline lung function. The Lunn-McNeil competing risks approach was used to assess if differences in risks for incident COPD events and CE were significant. Results: Over 44 years follow-up there were 85 incident COPD events and 266 incident CE. Low FEV1 and FEV1/VC and high LCI showed significantly stronger relationships with COPD events than CE (adjusted HRs per 1SD decrement and p-value for equal associations: FEV1; HRCOPD: 2.11 (1.66–2.68), HRCE: 1.30 (1.13–1.49) p < 0.001, FEV1/VC; HRCOPD 1.95 (1.60–2.36), HRCE 1.11 (0.98–1.26) p < 0.0001, LCI; HRCOPD: 1.58 (1.26–1.98), HRCE: 1.14 (1.00–1.31) p = 0.015. Low VC was significantly associated with both COPD and CE, but HRs were not significantly different between the outcomes (p-value for equal associations = 0.706). Conclusions: Low FEV1 and FEV1/VC and high LCI at baseline show significantly stronger relationships with future COPD events than CE. Low VC at baseline is similarly associated with future COPD events and CE. This indicates differences but also an important similarity in the “lung function profile” for developing incident COPD events or incident CE later in life.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic obstructive pulmonary disease, Coronary heart disease, Incidence, Lung clearance index, Mortality, Spirometry
in
Respiratory Medicine
volume
144
pages
6 pages
publisher
Elsevier
external identifiers
  • pmid:30366586
  • scopus:85054865826
ISSN
0954-6111
DOI
10.1016/j.rmed.2018.10.007
language
English
LU publication?
yes
id
8d81ff02-f0e7-41d4-b8f6-602c8ee2f8db
date added to LUP
2018-10-30 09:28:23
date last changed
2024-06-24 23:02:53
@article{8d81ff02-f0e7-41d4-b8f6-602c8ee2f8db,
  abstract     = {{<p>Background: Although reduced lung function is associated with both COPD and coronary events (CE), the pattern of lung function impairment could be different for the two outcomes. We examined different measures of lung function in relation to incident COPD events and CE in a population-based cohort. Methods: Baseline spirometry and lung clearance index (LCI) were assessed in 672 men aged 55 years. Outcomes included incident COPD events and CE (hospitalisation or mortality). Cox regression was used to obtain HRs per 1-standard deviation (SD) decrement in baseline lung function. The Lunn-McNeil competing risks approach was used to assess if differences in risks for incident COPD events and CE were significant. Results: Over 44 years follow-up there were 85 incident COPD events and 266 incident CE. Low FEV<sub>1</sub> and FEV<sub>1</sub>/VC and high LCI showed significantly stronger relationships with COPD events than CE (adjusted HRs per 1SD decrement and p-value for equal associations: FEV<sub>1</sub>; HR<sub>COPD</sub>: 2.11 (1.66–2.68), HR<sub>CE</sub>: 1.30 (1.13–1.49) p &lt; 0.001, FEV<sub>1</sub>/VC; HR<sub>COPD</sub> 1.95 (1.60–2.36), HR<sub>CE</sub> 1.11 (0.98–1.26) p &lt; 0.0001, LCI; HR<sub>COPD</sub>: 1.58 (1.26–1.98), HR<sub>CE</sub>: 1.14 (1.00–1.31) p = 0.015. Low VC was significantly associated with both COPD and CE, but HRs were not significantly different between the outcomes (p-value for equal associations = 0.706). Conclusions: Low FEV<sub>1</sub> and FEV<sub>1</sub>/VC and high LCI at baseline show significantly stronger relationships with future COPD events than CE. Low VC at baseline is similarly associated with future COPD events and CE. This indicates differences but also an important similarity in the “lung function profile” for developing incident COPD events or incident CE later in life.</p>}},
  author       = {{Zaigham, Suneela and Johnson, Linda and Wollmer, Per and Engström, Gunnar}},
  issn         = {{0954-6111}},
  keywords     = {{Chronic obstructive pulmonary disease; Coronary heart disease; Incidence; Lung clearance index; Mortality; Spirometry}},
  language     = {{eng}},
  pages        = {{68--73}},
  publisher    = {{Elsevier}},
  series       = {{Respiratory Medicine}},
  title        = {{Measures of low lung function and the prediction of incident COPD events and acute coronary events}},
  url          = {{http://dx.doi.org/10.1016/j.rmed.2018.10.007}},
  doi          = {{10.1016/j.rmed.2018.10.007}},
  volume       = {{144}},
  year         = {{2018}},
}