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Prevalence and clinical significance of pre- and post-bronchodilator airflow obstruction in COPD patients.

Prevalence and clinical significance of pre- and post-bronchodilator airflow obstruction in COPD patients.

Authors :
Lee HW
Lee JK
Kim Y
Ahn JH
Lee CY
Park YB
Yoon HK
Jung JY
Yoo KH
Kim DK
Source :
Pulmonary pharmacology & therapeutics [Pulm Pharmacol Ther] 2024 Dec; Vol. 87, pp. 102332. Date of Electronic Publication: 2024 Nov 17.
Publication Year :
2024

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by persistent airflow limitation. This study investigates the prevalence and clinical significance of pre-bronchodilator (PREO) and post-bronchodilator (POSTO) airflow obstruction in COPD.<br />Methods: This retrospective cohort study analyzed data from 3252 COPD patients aged ≥40 years, registered from January 2012 to December 2019 at 54 medical centers in South Korea. Patients were categorized into three groups: PREO & post-bronchodilator non-obstruction (POSTN), pre-bronchodilator non-obstruction (PREN) & POSTO, and PREO & POSTO. The primary outcome was moderate-to-severe exacerbation over 3 years. Secondary outcomes included GOLD group progression and rapid FEV₁ decline.<br />Results: The majority of patients (96.2 %) were in the PREO & POSTO group, with smaller proportions in the PREO & POSTN (2.8 %) and PREN & POSTO (1.0 %) groups. During the 3-year observation, 21.6 % of patients experienced moderate-to-severe exacerbations, 6.2 % exhibited GOLD group progression, and 20.0 % showed rapid FEV₁ decline. The PREO & POSTO group had a higher risk of exacerbations compared to the PREO & POSTN group (odds ratio = 8.33 [95 % CI = 1.53-45.4], P-value = 0.014), but this was not statistically significant in multivariable analysis. Post-bronchodilator spirometry patterns did not significantly impact GOLD group progression or FEV₁ decline.<br />Conclusion: PREO & POSTO was common among COPD patients, while isolated PREO & POSTN was rare, supportingpre-bronchodilator spirometry as a screening tool. Although patients with PREO & POSTO showed higher exacerbation risks in univariable analysis, statistical significance disappeared after adjustment. GOLD group progression or FEV₁ decline did not significantly differ by post-bronchodilator spirometry patterns.<br />Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Kwang Ha Yoo reports financial support was provided by Korea National Institute of Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2024. Published by Elsevier Ltd.)

Details

Language :
English
ISSN :
1522-9629
Volume :
87
Database :
MEDLINE
Journal :
Pulmonary pharmacology & therapeutics
Publication Type :
Academic Journal
Accession number :
39551446
Full Text :
https://doi.org/10.1016/j.pupt.2024.102332