Increased Risk of Exacerbation in Asthma Predominant Asthma–Chronic Obstructive Pulmonary Disease Overlap Syndrome
- Authors
- Park, Jisoo; Kim, Eun-Kyung; Kim, Mi-Ae; Kim, Tae-Hyung; Chang, Jung Hyun; Ryu, Yon Ju; Lee, Sei Won; Oh, Yeon-Mok; Yong, Suk Joong; Choi, Wonil; Yoo, Kwang Ha; Lee, Ji-Hyun
- Issue Date
- Oct-2018
- Publisher
- Korean National Tuberculosis Association
- Keywords
- Asthma; Pulmonary Disease; Chronic Obstructive; Phenotype
- Citation
- Tuberculosis and Respiratory Diseases, v.81, no.4, pp.289 - 298
- Indexed
- SCOPUS
KCI
- Journal Title
- Tuberculosis and Respiratory Diseases
- Volume
- 81
- Number
- 4
- Start Page
- 289
- End Page
- 298
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/190980
- DOI
- 10.4046/trd.2017.0064
- ISSN
- 1738-3536
- Abstract
- Background: Obstructive airway disease patients with increased variability of airflow and incompletely reversible airflow obstruction are often categorized as having asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). ACOS is heterogeneous with two sub-phenotypes: asthma-ACOS and COPD-ACOS. The objective of this study was to determine the difference in risk of exacerbation between the two sub-phenotypes of ACOS.
Methods: A total of 223 patients exhibiting incompletely reversible airflow obstruction with increased variability (spirometrically defined ACOS) were enrolled. These patients were divided into asthma-ACOS and COPD-ACOS according to their physician's diagnosis and smoking history of 10 pack-years. Within-group comparisons were made for asthma-ACOS versus COPD-ACOS and light smokers versus heavy smokers.
Results: Compared to patients with COPD-ACOS, patients with asthma-ACOS experienced exacerbation more often despite their younger age, history of light smoking, and better lung function. While the light-smoking group showed better lung function, they made unscheduled outpatient clinic visits more frequently. On multivariate analysis, asthma-ACOS and poor inhaler compliance were significantly associated with more than two unscheduled clinic visits during the previous year.
Conclusion: Spirometrically defined ACOS includes heterogeneous subgroups with different clinical features. Phenotyping of ACOS by physician's diagnosis could be significant in predicting future risk of exacerbation.
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