FEV1 is a stronger mortality predictor than FVC in patients with moderate copd and with an increased risk for cardiovascular disease
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
FEV1 is a stronger mortality predictor than FVC in patients with moderate copd and with an increased risk for cardiovascular disease. / Bikov, Andras; Lange, Peter; Anderson, Julie A.; Brook, Robert D.; Calverley, Peter M.A.; Celli, Bartolome R.; Cowans, Nicholas J.; Crim, Courtney; Dixon, Ian J.; Martinez, Fernando J.; Newby, David E.; Yates, Julie C.; Vestbo, Jørgen.
In: International Journal of COPD, Vol. 15, 2020, p. 1135-1142.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - FEV1 is a stronger mortality predictor than FVC in patients with moderate copd and with an increased risk for cardiovascular disease
AU - Bikov, Andras
AU - Lange, Peter
AU - Anderson, Julie A.
AU - Brook, Robert D.
AU - Calverley, Peter M.A.
AU - Celli, Bartolome R.
AU - Cowans, Nicholas J.
AU - Crim, Courtney
AU - Dixon, Ian J.
AU - Martinez, Fernando J.
AU - Newby, David E.
AU - Yates, Julie C.
AU - Vestbo, Jørgen
PY - 2020
Y1 - 2020
N2 - Purpose: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Impaired lung function is associated with heightened risk for death, cardiovascular events, and COPD exacerbations. However, it is unclear if forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) differ in predictive value. Patients and Methods: Data from 16,485 participants in the Study to Understand Mortality and Morbidity (SUMMIT) in COPD were analyzed. Patients were grouped into quintiles for each lung function parameter (FEV1 %predicted, FVC %predicted, FEV1/FVC). The four highest quintiles (Q2–Q5) were compared to the lowest (Q1) to assess their relationship with all-cause mortality, cardiovascular events, and moderate-to-severe and severe exacerbations. Cox-regression was used, adjusted for age, sex, ethnicity, body-mass index, smoking status, previous exacerbations, cardiovascular disease, treatment, and modified Medical Research Council dyspnea score. Results: Compared to Q1 (<53.5% FEV predicted), increasing FEV quintiles (Q2 53.5–457.5% 1 1 predicted, Q3 57.5–461.6% predicted, Q4 61.6–465.8% predicted, and Q5 ≥65.8%) were all associated with significantly decreased all-cause mortality (20% (4–34%), 28% (13–40%), 23% (7–36%), and 30% (15–42%) risk reduction, respectively). In contrast, a significant risk reduction (21% (4–35%)) was seen only between Q1 and Q5 quintiles of FVC. Neither FEV1 nor FVC was associated with cardiovascular risk. Increased FEV1 and FEV1/FVC quintiles were also associated with the reduction of moderate-to-severe and severe exacerbations while, surprisingly, the highest FVC quintile was related to the heightened exacerbation risk (28% (8–52%) risk increase). Conclusion: Our results suggest that FEV1 is a stronger predictor for all-cause mortality than FVC in moderate COPD patients with heightened cardiovascular risk and that subjects with moderate COPD have very different risks.
AB - Purpose: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Impaired lung function is associated with heightened risk for death, cardiovascular events, and COPD exacerbations. However, it is unclear if forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) differ in predictive value. Patients and Methods: Data from 16,485 participants in the Study to Understand Mortality and Morbidity (SUMMIT) in COPD were analyzed. Patients were grouped into quintiles for each lung function parameter (FEV1 %predicted, FVC %predicted, FEV1/FVC). The four highest quintiles (Q2–Q5) were compared to the lowest (Q1) to assess their relationship with all-cause mortality, cardiovascular events, and moderate-to-severe and severe exacerbations. Cox-regression was used, adjusted for age, sex, ethnicity, body-mass index, smoking status, previous exacerbations, cardiovascular disease, treatment, and modified Medical Research Council dyspnea score. Results: Compared to Q1 (<53.5% FEV predicted), increasing FEV quintiles (Q2 53.5–457.5% 1 1 predicted, Q3 57.5–461.6% predicted, Q4 61.6–465.8% predicted, and Q5 ≥65.8%) were all associated with significantly decreased all-cause mortality (20% (4–34%), 28% (13–40%), 23% (7–36%), and 30% (15–42%) risk reduction, respectively). In contrast, a significant risk reduction (21% (4–35%)) was seen only between Q1 and Q5 quintiles of FVC. Neither FEV1 nor FVC was associated with cardiovascular risk. Increased FEV1 and FEV1/FVC quintiles were also associated with the reduction of moderate-to-severe and severe exacerbations while, surprisingly, the highest FVC quintile was related to the heightened exacerbation risk (28% (8–52%) risk increase). Conclusion: Our results suggest that FEV1 is a stronger predictor for all-cause mortality than FVC in moderate COPD patients with heightened cardiovascular risk and that subjects with moderate COPD have very different risks.
KW - Airflow limitation
KW - Cardiovascular risk
KW - Death rate
KW - Exacerbation
KW - Lung function
KW - Lung volumes
U2 - 10.2147/COPD.S242809
DO - 10.2147/COPD.S242809
M3 - Journal article
C2 - 32547001
AN - SCOPUS:85085279117
VL - 15
SP - 1135
EP - 1142
JO - International Journal of COPD
JF - International Journal of COPD
SN - 1178-2005
ER -
ID: 242565471