C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease

Morten Dahl, Jørgen Vestbo, Peter Lange, Stig E. Bojesen, Anne Tybjærg-Hansen, Børge G. Nordestgaard*

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review


    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: Weperformed a cohort studywith amedian 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 ≤ 3 mg/L (log rank: p < 0.001). After adjusting for sex, age, FEV1% 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 ≤ 3 mg/L. After close matching for FEV1% 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 FEV1% predicted of less than 50. Conclusions: CRP is a strong and independent predictor of future COPD outcomes in individuals with airway obstruction.

    Sider (fra-til)250-255
    Antal sider6
    TidsskriftAmerican Journal of Respiratory and Critical Care Medicine
    Udgave nummer3
    StatusUdgivet - 1 feb. 2007


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