Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2018

Open Access 01-12-2018 | Research article

The influence of anemia on one-year exacerbation rate of patients with COPD-PH

Authors: Wei Xiong, Mei Xu, Bigyan Pudasaini, Xuejun Guo, Jinming Liu

Published in: BMC Pulmonary Medicine | Issue 1/2018

Login to get access

Abstract

Background

Anemia is prevalent not only in COPD but also in pulmonary hypertension. We postulated that anemia may have certain prognostic value in COPD concomitant with PH due to COPD (COPD-PH).

Methods

We performed a 12-month prospective investigation to follow up COPD patients with or without PH assessed by right heart catheterization. Eligible patients were enrolled, stratified into COPD-PH-anemia group (n = 40), COPD-PH group (n = 42), COPD-anemia group (n = 48), and COPD group(n = 50), and then followed up for 12 months.

Results

After the follow-up, for both of the actual variation value and variation rate, the increase of NT-pro BNP (P<0.001; P = 0.03) and CAT score (P = 0.001; 0.002), as well as the decrease of PaO2 (P = 0.03; 0.086) and Peak VO2 (P = 0.021; 0.009) in COPD-PH-anemia group were highest among four groups. The cumulative one-year survival rates were similar among four groups (P = 0.434). The cumulative exacerbation-free rate was lowest in COPD-PH-anemia group among four groups (P<0.001). Hemoglobin was an independent promoting factor for the probability of hospitalization due to exacerbation ≧ 1/year in patients with COPD-PH-anemia [HR 3.121(2.325–5.981); P<0.001].

Conclusions

Anemia is a promoting factor for the worsening of exercise capacity, deterioration of hypoxemia, declining of life quality, and aggravation of exacerbations in patients with COPD-PH-anemia, by contrast with COPD-PH, COPD-anemia, and COPD.
Literature
1.
go back to reference Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380:2095–128.CrossRefPubMed Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380:2095–128.CrossRefPubMed
2.
go back to reference Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010: findings from the global burden of disease study 2010. Lancet. 2013;381:1987–2015.CrossRefPubMed Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010: findings from the global burden of disease study 2010. Lancet. 2013;381:1987–2015.CrossRefPubMed
4.
go back to reference Galiè N, Humbert M, Vachiery J-L, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2015;46:879–82.CrossRef Galiè N, Humbert M, Vachiery J-L, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2015;46:879–82.CrossRef
5.
go back to reference Sakao S, Voelkel NF, Tatsumi K. The vascular bed in COPD: pulmonary hypertension and pulmonary vascular alterations. Eur Respir Rev. 2014;23(133):350–5.CrossRefPubMed Sakao S, Voelkel NF, Tatsumi K. The vascular bed in COPD: pulmonary hypertension and pulmonary vascular alterations. Eur Respir Rev. 2014;23(133):350–5.CrossRefPubMed
6.
go back to reference Peinado VI, Pizarro S, Barbera JA. Pulmonary vascular involvement in COPD. Chest. 2008;134(4):808–14.CrossRefPubMed Peinado VI, Pizarro S, Barbera JA. Pulmonary vascular involvement in COPD. Chest. 2008;134(4):808–14.CrossRefPubMed
8.
go back to reference Oswald-Mammosser M, Weitzenblum E, Quoix E, et al. Prognostic factors in COPD patients receiving long-term oxygen therapy. Importance of pulmonary artery pressure. Chest. 1995;107:1193–8.CrossRefPubMed Oswald-Mammosser M, Weitzenblum E, Quoix E, et al. Prognostic factors in COPD patients receiving long-term oxygen therapy. Importance of pulmonary artery pressure. Chest. 1995;107:1193–8.CrossRefPubMed
9.
go back to reference Kessler R, Faller M, Weitzenblum E, et al. “Natural history” of pulmonary hypertension in a series of 131 patients with chronic obstructive lung disease. Am J Respir Crit Care Med. 2001;164:219–24.CrossRefPubMed Kessler R, Faller M, Weitzenblum E, et al. “Natural history” of pulmonary hypertension in a series of 131 patients with chronic obstructive lung disease. Am J Respir Crit Care Med. 2001;164:219–24.CrossRefPubMed
10.
go back to reference Lettieri CJ, Nathan SD, Barnett SD, et al. Prevalence and outcomes of pulmonary arterial hypertension in advanced idiopathic pulmonary fibrosis. Chest. 2006;129:746–52.CrossRefPubMed Lettieri CJ, Nathan SD, Barnett SD, et al. Prevalence and outcomes of pulmonary arterial hypertension in advanced idiopathic pulmonary fibrosis. Chest. 2006;129:746–52.CrossRefPubMed
12.
go back to reference Ruiter G, Lankhorst S, Boonstra A, et al. Iron deficiency is common in idiopathic pulmonary arterial hypertension. Eur Respir J. 2011;37:1386–91.CrossRefPubMed Ruiter G, Lankhorst S, Boonstra A, et al. Iron deficiency is common in idiopathic pulmonary arterial hypertension. Eur Respir J. 2011;37:1386–91.CrossRefPubMed
13.
go back to reference Ruiter G, Lanser IJ, de Man FS, et al. Iron deficiency in systemic sclerosis patients with and without pulmonary hypertension. Rheumatology (Oxford). 2014;53:285–92.CrossRef Ruiter G, Lanser IJ, de Man FS, et al. Iron deficiency in systemic sclerosis patients with and without pulmonary hypertension. Rheumatology (Oxford). 2014;53:285–92.CrossRef
14.
go back to reference Broberg CS, Bax BE, Okonko DO, et al. Blood viscosity and its relationship to iron deficiency, symptoms, and exercise capacity in adults with cyanotic congenital heart disease. J Am Coll Cardiol. 2006;48:356–65.CrossRefPubMed Broberg CS, Bax BE, Okonko DO, et al. Blood viscosity and its relationship to iron deficiency, symptoms, and exercise capacity in adults with cyanotic congenital heart disease. J Am Coll Cardiol. 2006;48:356–65.CrossRefPubMed
15.
go back to reference Rhodes CJ, Howard LS, Busbridge M, et al. Iron deficiency and raised hepcidin in idiopathic pulmonary arterial hypertension clinical prevalence, outcomes, and mechanistic insights. J Am Coll Cardiol. 2011;58:300–9.CrossRefPubMed Rhodes CJ, Howard LS, Busbridge M, et al. Iron deficiency and raised hepcidin in idiopathic pulmonary arterial hypertension clinical prevalence, outcomes, and mechanistic insights. J Am Coll Cardiol. 2011;58:300–9.CrossRefPubMed
16.
go back to reference Van De Bruaene A, Delcroix M, Pasquet A, et al. Iron deficiency is associated with adverse outcome in Eisenmenger patients. Eur Heart J. 2011;32:2790–9.CrossRefPubMed Van De Bruaene A, Delcroix M, Pasquet A, et al. Iron deficiency is associated with adverse outcome in Eisenmenger patients. Eur Heart J. 2011;32:2790–9.CrossRefPubMed
17.
go back to reference World Health Organization. Iron deficiency anemia. assessment, prevention, and control. A guide for programme managers. Geneva: WHO; 2001. World Health Organization. Iron deficiency anemia. assessment, prevention, and control. A guide for programme managers. Geneva: WHO; 2001.
18.
go back to reference Wedzicha JA, Seemungal TA. COPD exacerbations: defining their cause and prevention. Lancet. 2007;370(9589):786–96.CrossRefPubMed Wedzicha JA, Seemungal TA. COPD exacerbations: defining their cause and prevention. Lancet. 2007;370(9589):786–96.CrossRefPubMed
19.
go back to reference Seemungal TA, Donaldson GC, Paul EA, et al. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157(5Pt1):1418–22.CrossRefPubMed Seemungal TA, Donaldson GC, Paul EA, et al. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157(5Pt1):1418–22.CrossRefPubMed
20.
go back to reference Pernille A, Petersen T, Pedersen CT, et al. Association between hemoglobin and prognosis in patients admitted to hospital for COPD. Int J COPD. 2016;11:2813–20.CrossRef Pernille A, Petersen T, Pedersen CT, et al. Association between hemoglobin and prognosis in patients admitted to hospital for COPD. Int J COPD. 2016;11:2813–20.CrossRef
21.
go back to reference Yasuda H, Yamaya M, Nakayama K, et al. Increased arterial carboxyhemoglobin concentrations in chronic obstructive pulmonary disease. Am J Respir Crit Care. 2005;171:1246–51.CrossRef Yasuda H, Yamaya M, Nakayama K, et al. Increased arterial carboxyhemoglobin concentrations in chronic obstructive pulmonary disease. Am J Respir Crit Care. 2005;171:1246–51.CrossRef
23.
24.
go back to reference Markoulaki D, Kostikas K, Papatheodorou G, et al. Hemoglobin, erythropoietin and systemic inflammation in exacerbations of chronic obstructive pulmonary disease. Eur J Intern Med. 2011;22:103–7.CrossRefPubMed Markoulaki D, Kostikas K, Papatheodorou G, et al. Hemoglobin, erythropoietin and systemic inflammation in exacerbations of chronic obstructive pulmonary disease. Eur J Intern Med. 2011;22:103–7.CrossRefPubMed
25.
go back to reference Tanner H, Moschovitis G, Kuster GM, et al. The prevalence of anemia in chronic heart failure. Int J Cardiol. 2002;86:115–21.CrossRefPubMed Tanner H, Moschovitis G, Kuster GM, et al. The prevalence of anemia in chronic heart failure. Int J Cardiol. 2002;86:115–21.CrossRefPubMed
26.
27.
go back to reference Ezekowitz JA, McAlister FA, Armstrong PW. Anemia is common in heart failure and is associated with poor outcomes: insights from a cohort of 12065 patients with new-onset heart failure. Circulation. 2003;107:223–5.CrossRefPubMed Ezekowitz JA, McAlister FA, Armstrong PW. Anemia is common in heart failure and is associated with poor outcomes: insights from a cohort of 12065 patients with new-onset heart failure. Circulation. 2003;107:223–5.CrossRefPubMed
28.
go back to reference Okonko DO, Anker SD. Anemia in chronic heart failure: pathogenetic mechanisms. J Card Fail. 2004;10(Suppl. 1):S5–9.CrossRefPubMed Okonko DO, Anker SD. Anemia in chronic heart failure: pathogenetic mechanisms. J Card Fail. 2004;10(Suppl. 1):S5–9.CrossRefPubMed
Metadata
Title
The influence of anemia on one-year exacerbation rate of patients with COPD-PH
Authors
Wei Xiong
Mei Xu
Bigyan Pudasaini
Xuejun Guo
Jinming Liu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2018
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-018-0693-6

Other articles of this Issue 1/2018

BMC Pulmonary Medicine 1/2018 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.