ATS 2019—Asthma-COPD overlap linked to increased mortality, COPD events


  • Tara Haelle
  • Conference Reports
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.