Author(s): Dahl M, Vestbo J, Lange P, Bojesen SE, TybjaergHansen A,
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Abstract RATIONALE: Patients with chronic obstructive pulmonary disease (COPD) have an ongoing systemic inflammation, which can be assessed by measuring serum C-reactive protein (CRP). OBJECTIVE: To determine whether increased serum CRP in individuals with airway obstruction predicts future hospitalization and death from COPD. METHODS: We performed a cohort study with a median of 8-yr follow-up of 1,302 individuals with airway obstruction selected from the ongoing Copenhagen City Heart Study. MEASUREMENTS AND MAIN RESULTS: We measured serum CRP at baseline, and recorded COPD admissions and deaths as outcomes. During follow-up, 185 (14\%) individuals were hospitalized due to COPD and 83 (6\%) died of COPD. Incidences of COPD hospitalization and COPD death were increased in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L (log rank: p < 0.001). After adjusting for sex, age, FEV(1)\% predicted, tobacco consumption, and ischemic heart disease, the hazard ratios for hospitalization and death due to COPD were increased at 1.4 (95\% confidence interval, 1.0-2.0) and 2.2 (1.2-3.9) in individuals with baseline CRP > 3 mg/L versus < or = 3 mg/L. After close matching for FEV(1)\% predicted and adjusting for potential confounders, baseline CRP was, on average, increased by 1.2 mg/L (analysis of variance: p = 0.002) and 4.1 mg/L (p = 0.001) in those who were subsequently hospitalized or died of COPD, respectively. The absolute 10-yr risks for COPD hospitalization and death in individuals with CRP above 3 mg/L were 54 and 57\%, respectively, among those older than 70 yr with a tobacco consumption above 15 g/d and an FEV(1)\% predicted of less than 50. CONCLUSIONS: CRP is a strong and independent predictor of future COPD outcomes in individuals with airway obstruction.
This article was published in Am J Respir Crit Care Med
and referenced in Journal of Pulmonary & Respiratory Medicine