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Inflammatory Biomarkers Up Risk of Exacerbations in COPD

Elevated levels linked to increased risk of exacerbations, even for those with milder COPD
TUESDAY, June 11 (HealthDay News) -- For patients with chronic obstructive pulmonary disease (COPD), including those with milder COPD, elevated levels of inflammatory biomarkers correlate with an increased risk of exacerbations, according to a study published in the June 12 issue of the Journal of the American Medical Association.
Mette Thomsen, M.D., from the Copenhagen University Hospital in Denmark, and colleagues conducted a prospective cohort study involving 61,650 participants with spirometry measurements, of which 6,574 had COPD, to examine whether elevated levels of biomarkers (C-reactive protein [CRP] and fibrinogen and leukocyte count) correlate with an increased risk of exacerbations in individuals with stable COPD.
During follow-up, the researchers identified 3,083 exacerbations, with a mean of 0.5 per participant. The multivariate-adjusted odds ratios for having frequent exacerbations in the first year of follow-up were 1.2, 1.7, and 3.7, respectively, for those with one, two, and three elevated biomarkers, compared to those with no high biomarkers. At maximum follow-up, the corresponding hazard ratios were 1.4, 1.6, and 2.5. For those with milder COPD and those with no history of exacerbations, the relative risks were consistent.
"Simultaneously elevated levels of CRP and fibrinogen and leukocyte count were associated with increased risk of exacerbations in stable COPD, even for individuals with milder COPD and for those without previous exacerbations," the authors write. "Further investigation is needed to determine the clinical value of these biomarkers for risk stratification."
Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1696097#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1696097 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1696083 )
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