Prevalence of persistent blood eosinophilia: relation to outcomes in patients with COPD. Issue 5 (23rd November 2017)

• Record Type: Journal Article
• Authors: Casanova, Ciro; Celli, Bartolome R.; de-Torres, Juan P.; Martínez-Gonzalez, Cristina; Cosio, Borja G.; Pinto-Plata, Victor; de Lucas-Ramos, Pilar; Divo, Miguel; Fuster, Antonia; Peces-Barba, Germán; Calle-Rubio, Myriam; Solanes, Ingrid; Aguero, Ramón; Feu-Collado, Nuria; Alfageme, Inmaculada; De Diego, Alfredo; Romero, Amparo; Balcells, Eva; Llunell, Antonia; Galdiz, Juan B.; Marin, Margarita; Moreno, Amalia; Cabrera, Carlos; Golpe, Rafael; Lacarcel, Celia; Soriano, Joan B.; López-Campos, José Luis; Soler-Cataluña, Juan J.; Marin, José M.
• Is Part Of: European respiratory journal. Volume 50:Issue 5(2017)
• Publication Date: 2017-11-23
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01162-2017
• Languages: English
• ISSNs: 0903-1936

Abstract

The impact of blood eosinophilia in chronic obstructive pulmonary disease (COPD) remains controversial. To evaluate the prevalence and stability of a high level of blood eosinophils (≥300 cells·μL –1 ) and its relationship to outcomes, we determined blood eosinophils at baseline and over 2 years in 424 COPD patients (forced expiratory volume in 1 s (FEV1 ) 60% predicted) and 67 smokers without COPD from the CHAIN cohort, and in 308 COPD patients (FEV1 60% predicted) in the BODE cohort. We related eosinophil levels to exacerbations and survival using Cox hazard analysis. In COPD patients, 15.8% in the CHAIN cohort and 12.3% in the BODE cohort had persistently elevated blood eosinophils at all three visits. A significant proportion (43.8%) of patients had counts that oscillated above and below the cut-off points, while the rest had persistent eosinophil levels <300 cells·μL –1 . A similar eosinophil blood pattern was observed in controls. Exacerbation rates did not differ in patients with and without eosinophilia. All-cause mortality was lower in patients with high eosinophils compared with those with values <300 cells·μL –1 (15.8% versus 33.7%; p=0.026). In patients with COPD, blood eosinophils ≥300 cells·μL –1 persisting over 2 years was not a risk factor for COPD exacerbations. High eosinophil count was associated with better survival. The stability of blood eosinophils ≥300 cells per μL is low in COPD patients and it does not confer a poor prognosis http://ow.ly/TwGX30etVIy