Journal article
Respiratory Exacerbations and Lung Function Decline in People with Smoking History and Normal Spirometry
American journal of respiratory and critical care medicine, Vol.211(6), pp.957-965
06/2025
DOI: 10.1164/rccm.202401-0023OC
PMCID: PMC12175941
PMID: 39946437
Abstract
The impact of respiratory exacerbation on chronic obstructive pulmonary disease (COPD) is well established. The effects of respiratory exacerbations in people with cigarette smoking but normal spirometry are unknown.
To assess the association of respiratory exacerbations with lung function decline and mortality in people with normal spirometry and current or former cigarette smoking history.
We analyzed data from COPDGene participants with ≥10 pack-years cigarette smoking and normal spirometry at enrollment (Visit 1) defined as post-bronchodilator forced expiratory volume in 1 second (FEV
)/forced vital capacity (FVC) ≥lower limit of normal (LLN) and FEV
≥LLN. We examined whether respiratory exacerbations occurring between Visits 1 and the 5-year follow-up visit (Visit 2) were associated with FEV
decline, and all-cause mortality.
Among 2,939 participants with cigarette smoking history and normal lung function at Visit 1, each additional exacerbation between visit 1 and 2 was associated with a 2.96 ml/year FEV
decline (95%CI 1.81 to 4.12; P<0.001) at Visit 2. Experiencing ≥1 severe exacerbation between Visits 1 and 2 was associated with 14.6 ml/year FEV
decline relative to those with no severe exacerbations (95% CI 8.56 to 20.6; P<0.001). Individuals with ≥1 severe exacerbation between Visits 1 and 2 had increased mortality compared to those with no severe exacerbations (17.1% vs. 9.8%; adjusted hazard ratio 1.97;95% CI 1.40 to 2.77; P<0.001).
Respiratory exacerbations in people with cigarette smoking but normal spirometry were associated lung function decline. Experiencing a severe respiratory exacerbation was associated with increased mortality.
Details
- Title: Subtitle
- Respiratory Exacerbations and Lung Function Decline in People with Smoking History and Normal Spirometry
- Creators
- Spyridon Fortis - University of Iowa Hospitals and ClinicsMatthew Strand - National Jewish HealthSurya P Bhatt - University of Alabama at BirminghamPatrick Ten Eyck - University of Iowa, BiostatisticsLinder Wendt - University of IowaTrisha Parekh - Seton Medical Center AustinMeiLan K Han - Michigan MedicineJohn E Hokanson - Colorado School of Public HealthGregory Kinney - Colorado School of Public HealthJeffrey L Curtis - Michigan MedicineRussell P Bowler - National Jewish HealthEmily S Wan - Brigham and Women's HospitalKen M Kunisaki - University of MinnesotaChris H Wendt - Minneapolis VA Health Care SystemElizabeth Regan - National Jewish HealthMark Dransfield - University of Alabama at BirminghamJames D Crapo - National Jewish HealthEdwin K Silverman - Brigham and Women's HospitalAlejandro P Comellas - University of Iowa
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.211(6), pp.957-965
- DOI
- 10.1164/rccm.202401-0023OC
- PMID
- 39946437
- PMCID
- PMC12175941
- NLM abbreviation
- Am J Respir Crit Care Med
- ISSN
- 1535-4970
- eISSN
- 1535-4970
- Publisher
- AMER THORACIC SOC; NEW YORK
- Grant note
- NIH from the National Heart, Lung, and Blood Institute: U01 HL089897, U01 HL089856, 75N92023D00011 U.S. Department of Veterans Affairs Clinical Science Research and Development Service: CX002193 COPD Foundation
Supported by award number U01 HL089897, award number U01 HL089856, and NIH contract 75N92023D00011 from the National Heart, Lung, and Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. COPDGene is also supported by the COPD Foundation through contributions made to an industry advisory board that has included AstraZeneca, Bayer Pharmaceuticals, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Novartis, Pfizer, and Sunovion. E.S.W. is supported by U.S. Department of Veterans Affairs Clinical Science Research and Development Service grant CX002193.
- Language
- English
- Electronic publication date
- 02/13/2025
- Date published
- 06/2025
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Psychiatry; ICTS; Biostatistics; Internal Medicine; Design Biostat and Ethics
- Record Identifier
- 9984790971202771
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