Analysis of the Comorbid Course of Chronic Obstructive Pulmonary Disease

Abstract

(1) Background. Chronic obstructive pulmonary disease (COPD) has a heterogeneous natural history, manifested both in the variability of clinical features and in association with various comorbid pathologies. Atherosclerotic cardiovascular disease (ASCVD) is of great clinical importance and contributes significantly to the natural history and prognosis of COPD. The present study aimed to evaluate the nature of the comorbid course of COPD during a 15-year follow-up. (2) Methods: A total of 170 male COPD patients were included in this study. Spirometry values, symptom severity, presence of risk factors, and comorbidities were considered. Prognostic factors were evaluated using the Kaplan–Meier method. (3) Results: ASCVD was the most common comorbidity and the main cause of death in patients with COPD. Patients with comorbid COPD and ASCVD had more severe dyspnea, higher frequency of COPD exacerbations, and worse survival than patients without ASCVD (p < 0.01). Among patients with COPD, the risk of death from ASCVD was higher in those older than 60 years (OR 3.23, 95% CI [1.72, 6.07]), those with rapidly declining FEV1 (OR 4.35, 95% CI [2.28, 8.30]), those with more than two exacerbations per year (OR 3.21, 95% CI [1.71, 6.11]), and those with a pack year index greater than 30 (OR 2.75, 95% CI [1.38, 5.51]. High Charlson comorbidity index scores in patients with COPD were associated with a more severe disease course, including severity of dyspnea, frequency of exacerbations, and multivariate index scores. A high Charlson comorbidity index score was an adverse prognostic factor. (4) Conclusions: ASCVD influences the course of the disease and is a major cause of mortality in COPD patients.

Machine learning-based bioinformatics analysis of common hub genes associated with oxidative stress and immune infiltration in COPD and atherosclerosis Running title: Bioinformatics analysis of common hub OS genes in COPD and Atherosclerosis

“…As early as more than a decade ago, Topsakal et al found that the severity and intensity of atherosclerosis in COPD patients increased, and speculated that chronic OS and in ammation associated with COPD may be the cause of driving coronary atherosclerosis in these patients [26]. The occurrence of COPD patients with AS has also been continuously found in subsequent clinical studies [27,28]. A metabolomics analysis provided evidence for this phenomenon and found that the carnitine/acylcarnitine ratio of COPD patients was lower than that of healthy controls, suggesting the existence of atherosclerosis susceptibility and OS caused by insu cient fatty acid β-oxidation [29].…”

The Role of the Cumulative Illness Rating Scale (CIRS) in Estimating the Impact of Comorbidities on Chronic Obstructive Pulmonary Disease (COPD) Outcomes: A Pilot Study of the MACH (Multidimensional Approach for COPD and High Complexity) Study

“…A meta-analysis by Putcha et al showed that approximately 86% to 98% of COPD patients have at least one comorbidity (average number of comorbidities per individual = 1.2-4) [3]. The overlap between high levels of comorbidity and COPD is associated with a poor 2 of 12 clinical and prognostic outcome: poorer quality of life and increased risk of exacerbations, hospitalization, and mortality [4][5][6][7]. This finding is similar to what has been found in studies of the role of comorbid conditions in other chronic respiratory diseases, such as asthma [8,9].…”