- Patients with asthma-COPD overlap (ACO) have increased risk of mortality and COPD events compared with asthma or COPD alone.
Why this matters
- Separate treatment and prevalence tracking of asthma and COPD may preclude coordinated care or neglect increased risk for poor outcomes for dual diagnosis.
- National Heart, Lung, and Blood Institute pooled cohort study with 38,180 participants: 1910 asthma-only, 4735 COPD-only, 468 ACO (1.2%), and 31,067 controls.
- ACO defined as self-reported asthma and COPD (>40 years old, FEV1/FVC 10 [smoking] pack-years).
- Adjusted for age, sex, race/ethnicity, height, weight, education, birth year, location, smoking status, pack-years, and major comorbidities.
- Funding: NIH.
- Baseline FEV1/FVC was lower with ACO (56.8%) vs COPD (61.9%) or asthma (73.7%) alone; median pack-years 36.7 ACO vs 38.5 COPD.
- Increased risk of COPD events (primary cause COPD/bronchitis/emphysema) with ACO vs COPD-only (HR, 1.45; P=.001).
- All-cause mortality risk increased for ACO (HR, 1.65; 95% CI, 1.45-1.86) and COPD-only (HR, 1.33; 95% CI, 1.26-1.40) but not asthma-only compared with no respiratory diseases (P<.01>
- No increased risk of asthma events with ACO vs asthma-only.