Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis
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Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis. / 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.
In: THORAX, Vol. 74, No. 5, 05.2019, p. 439-446.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis
AU - Fermont, Jilles M
AU - Masconi, Katya L
AU - Jensen, Magnus T
AU - Ferrari, Renata
AU - Di Lorenzo, Valéria A P
AU - Marott, Jacob M
AU - Schuetz, Philipp
AU - Watz, Henrik
AU - Waschki, Benjamin
AU - Müllerova, Hana
AU - Polkey, Michael I
AU - Wilkinson, Ian B
AU - Wood, Angela M
N1 - © 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.
PY - 2019/5
Y1 - 2019/5
N2 - BACKGROUND: 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.OBJECTIVE: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.TRIAL REGISTRATION NUMBER: CRD42016052075.
AB - BACKGROUND: 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.OBJECTIVE: 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.METHODS: 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.RESULTS: 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.CONCLUSION: 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.TRIAL REGISTRATION NUMBER: CRD42016052075.
KW - Biomarkers/metabolism
KW - Exercise Test
KW - Hemodynamics/physiology
KW - Humans
KW - Pulmonary Disease, Chronic Obstructive/diagnosis
KW - Respiratory Function Tests
KW - Severity of Illness Index
U2 - 10.1136/thoraxjnl-2018-211855
DO - 10.1136/thoraxjnl-2018-211855
M3 - SCORING: Journal article
C2 - 30617161
VL - 74
SP - 439
EP - 446
JO - THORAX
JF - THORAX
SN - 0040-6376
IS - 5
ER -
