Complex chronic comorbidities of COPD
Open accessAbstract
Chronic obstructive pulmonary disease (COPD) is defined by fixed airflow limitation associated with an abnormal pulmonary and systemic inflammatory response of the lungs to cigarette smoke. The systemic inflammation induced by smoking may also cause chronic heart failure, metabolic syndrome and other chronic diseases, which may contribute to the clinical manifestations and natural history of COPD. Thus COPD can no longer be considered a disease only of the lungs, as it is often associated with a wide variety of systemic consequences. A better understanding of the origin and consequences of systemic inflammation, and of potential therapies, will most likely lead to better care of patients with COPD. Medical textbooks and clinical guidelines still largely ignore the fact that COPD seldom occurs in isolation. As the diagnosis and assessment of severity of COPD may be greatly affected by the presence of comorbid conditions, the current authors believe that lung function measurement, noninvasive assessment of cardiovascular and metabolic functions, and circulating inflammatory markers (e.g. C-reactive protein) might help to better characterise these patients. Similarly, preventive and therapeutic interventions should address the patient in their complexity.
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“Hypertension is likely to be the most frequently occurring comorbidity in COPD and may have implications for prognosis.(308,324)”
BackgroundSelf-citationThe Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019)
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“Because the association with these other diseases seems to be stronger in patients with COPD than in patients without the disease (16), Fabbri and coworkers (31) proposed that perhaps COPD was just one more manifestation of a systemic inflammatory syndrome.”
BackgroundChronic obstructive pulmonary disease
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“73, 74 No randomised controlled trials have yet been done to investigate whether treatment with broncho dilators or inhaled corticosteroids reduces the prevalence or severity of comorbidities.”
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“COPD is rarely seen in isolation but rather is often managed with comorbidities including heart failure, lung cancer, diabetes, hypertension, and dyslipidemia.(8) Systemic inflammation likely plays a key role in the development of these concomitant disease states, and elevated biomarkers such as C-reactive protein are…”
BackgroundPostma, D. S., Brightling, C. E., Baldi, S., van den Berge, M., Fabbri, L. M., Gagnatelli, A., Papi, A. A., van der Molen, T., Rabe, K. F., Siddiqui, S., et al. (2019) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(19)30049-9 · Cited by 409 · see citing works
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Chronic renal failure: a neglected comorbidity of COPD.
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“diabetes, cancer, and/or other conditions associated with different causes of muscle dysfunction (30).”
BackgroundCOPD and multimorbidity: Recognising and addressing a syndemic occurrence
Fabbri, L. M., Celli, B. R., Agustí, A., Criner, G. J., Dransfield, M. T., Divo, M., Krishnan, J. K., Lahousse, L., Montes de Oca, M., Salvi, S. S., et al. (2023) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(23)00261-8 · Cited by 274 · see citing works
Self-citationThe Metabolic Syndrome in Patients With Chronic Bronchitis and COPD
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“68 71 Diabetes worsens the outcomes of COPD by affecting a number of parameters: 66,72,73 shortening time to first hospitalization and increasing hospitalization time and risk of death during exacerbations, 74 increasing Medical Research Council dyspnea scores, and reducing six-minute walking…”
Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea
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Systemic Manifestations of COPD
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Inflammatory Biomarkers and Comorbidities in Chronic Obstructive Pulmonary Disease
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Comorbidities and Short-term Prognosis in Patients Hospitalized for Acute Exacerbation of COPD
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Comorbidities, Patient Knowledge, and Disease Management in a National Sample of Patients with COPD
Barr, R. G., Celli, B. R., Mannino, D. M., Petty, T. L., Rennard, S. I., Sciurba, F. C., Stoller, J. K., Thomashow, B. M., & Turino, G. M. (2009) · The American Journal of Medicine · doi:10.1016/j.amjmed.2008.09.042 · Cited by 223 · see citing works
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Diabetes and Lung Disease: An Underestimated Relationship
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Chronic bronchitis before age 50 years predicts incident airflow limitation and mortality risk
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“There is now convincing evidence that in COPD airway inflammation may extend beyond the lung to systemic inflammation(14-20), which, in turn, has been implicated in the systemic manifestations and excess mortality risk of this disease(21).”
BackgroundAirflow Limitation in Smokers Is Associated with Subclinical Atherosclerosis
Iwamoto, H., Yokoyama, A., Kitahara, Y., Ishikawa, N., Haruta, Y., Yamane, K., Hattori, N., Hara, H., & Kohno, N. (2008) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200804-560oc · Cited by 189 · see citing works
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“Moreover, continued systemic inflammation promotes the formation of atherosclerotic plaques, giving rise to cardiovascular comorbidity in COPD patients (Fabbri et al., 2008; Mizuno, Jacob, & Mason, 2011).”
BackgroundThe Diabetic Lung - A New Target Organ?
Pitocco, D., Fuso, L., Conte, E. G., Zaccardi, F., Condoluci, C., Scavone, G., Incalzi, R. A., & Ghirlanda, G. (2012) · The Review of Diabetic Studies · doi:10.1900/rds.2012.9.23 · Cited by 178 · see citing works
“Thus, both systemic and pulmonary inflammation may be implicated in the complex interplay between respiratory and metabolic dysfunction [20].”
BackgroundFletcher, M. J., Upton, J., Taylor-Fishwick, J. C., Buist, S. A., Jenkins, C. R., Hutton, J., Barnes, N. C., van der Molen, T., Walsh, J. W., Jones, P., et al. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-612 · Cited by 156 · see citing works
“It is recognised that comorbid diseases commonly occur with COPD [9-11].”
BackgroundThe Diagnosis and Treatment of COPD and Its Comorbidities.
Kahnert, K., Jörres, R. A., Behr, J., & Welte, T. (2023) · PubMed Central · doi:10.3238/arztebl.m2023.027 · Cited by 145 · see citing works
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Chronic obstructive pulmonary disease and cerebrovascular disease: A comprehensive review
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A Postmortem Analysis of Major Causes of Early Death in Patients Hospitalized With COPD Exacerbation
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COPD: early diagnosis and treatment to slow disease progression
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Burgel, P., Escamilla, R., Perez, T., Carré, P., Caillaud, D. M., Chanez, P., Pinet, C., Jébrak, G., Brinchault, G., Court‐Fortune, I., et al. (2012) · Respiratory Medicine · doi:10.1016/j.rmed.2012.10.002 · Cited by 128 · see citing works
Efficacy of standard rehabilitation in COPD outpatients with comorbidities
Crisafulli, E., Gorgone, P., Vagaggini, B., Pagani, M., Rossi, G., Costa, F., Guarriello, V., Paggiaro, P., Chetta, A. A., Blasio, F. D., et al. (2010) · European Respiratory Journal · doi:10.1183/09031936.00203809 · Cited by 127 · see citing works
“So far, it has been pointed out that Chronic Obstructive Pulmonary Disease (COPD), a common disease in the older population, is often associated with co-morbidities (5-8), sharing systemic pathological features with some of them (6,9).”
BackgroundAn Official American Thoracic Society Workshop Report: The Integrated Care of the COPD Patient
Nici, L. L., & ZuWallack, R. (2012) · Proceedings of the American Thoracic Society · doi:10.1513/pats.201201-014st · Cited by 126 · see citing works
“Their concept of proactive integrated care included four interventions: (1) disease-specific education, (2) teaching selfmanagement strategies, (3) enhanced communication with study coordinators, and (4) remote home monitoring.”
BackgroundMethodInfluentialAsthma and comorbid medical illness
Cazzola, M., Calzetta, L., Bettoncelli, G., Novelli, L., Cricelli, C. A., & Rogliani, P. (2010) · European Respiratory Journal · doi:10.1183/09031936.00140310 · Cited by 123 · see citing works
Accelerated lung aging: a novel pathogenic mechanism of chronic obstructive pulmonary disease (COPD)
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Water-based exercise in COPD with physical comorbidities: a randomised controlled trial
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Biomarkers of systemic inflammation and depression and fatigue in moderate clinically stable COPD
Al-shair, K., Kolsum, U., Dockry, R., Morris, J., Singh, D., & Vestbo, J. (2011) · Respiratory Research · doi:10.1186/1465-9921-12-3 · Cited by 118 · see citing works
“It has been suggested that systemic manifestations may be related to systemic inflammation in COPD [2,3].”
BackgroundTreatment of COPD: the sooner the better?
Decramer, M., & Cooper, C. B. (2010) · Thorax · doi:10.1136/thx.2009.133355 · Cited by 114 · see citing works
Ho, T., Tsai, Y., Ruan, S., Huang, C., Lai, F., Yu, C., & The HINT Study Group (2014) · PLoS ONE · doi:10.1371/journal.pone.0114866 · Cited by 115 · see citing works
“[1, 27] Angiotensin II receptor blockers, b blockers and statins are commonly used therapeutic drug classes in the management of cardiovascular patients and many trials have demonstrated their protective effects on cardiovascular outcomes.”
BackgroundComorbidities and Burden of COPD: A Population Based Case-Control Study
Baty, F., Putora, P. M., Isenring, B. D., Blum, T. G., & Brutsche, M. H. (2013) · PLoS ONE · doi:10.1371/journal.pone.0063285 · Cited by 109 · see citing works
Cardiovascular disease in asthma and COPD: A population-based retrospective cross-sectional study
Cazzola, M., Calzetta, L., Bettoncelli, G., Cricelli, C. A., Romeo, F., Matera, M. G., & Rogliani, P. (2011) · Respiratory Medicine · doi:10.1016/j.rmed.2011.07.021 · Cited by 109 · see citing works
Airflow obstruction and metabolic syndrome: the Guangzhou Biobank Cohort Study
Lam, H. K. B., Jordan, R. E., Jiang, C. Q., Thomas, G. N., Miller, M. R., Zhang, W. S., Lam, T., Cheng, K. K., & Adab, P. (2009) · European Respiratory Journal · doi:10.1183/09031936.00024709 · Cited by 109 · see citing works
“At present most chronic conditions are managed according to clinical guidelines that were designed to cater for the specific needs of individual diseases with little reference to multimorbidity [1, 2].”
BackgroundSode, B. F., Dahl, M., & Nordestgaard, B. G. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr338 · Cited by 108 · see citing works
“However, there are different alternative suggestions as to the cause for association between chronic obstructive pulmonary disease and its co-morbidities, including inflammation.(1,12) –15 For myocardial infarction, the likely explanation of the life-time association with chronic obstructive pulmonary disease is commo…”
BackgroundRisk factors and comorbidities in the preclinical stages of chronic obstructive pulmonary disease.
van Remoortel, H., Hornikx, M., Langer, D., Burtin, C., Everaerts, S., Verhamme, P., Boonen, S., Gosselink, R., Decramer, M., Troosters, T., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201307-1240oc · Cited by 122 · see citing works
Su, Y.-C., Jalalvand, F., Thegerström, J., & Riesbeck, K. (2018) · Frontiers in Immunology · doi:10.3389/fimmu.2018.02530 · Cited by 107 · see citing works
“Although COPD mainly affects the lungs, it also produces significant extrapulmonary consequences as a results of an escalated inflammatory response orchestrated by airway cells and immune mediators (20, 21).”
BackgroundÇolak, Y., Afzal, S., Nordestgaard, B. G., & Lange, P. (2015) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201502-0302oc · Cited by 104 · see citing works
Agustí, A. G. N., Hurd, S. S., Jones, P., Fabbri, L. M., Martínez, F. J., Vogelmeier, C. F., Vestbo, J., & Rodriguez‐Roisin, R. (2013) · European Respiratory Journal · doi:10.1183/09031936.00036513 · Cited by 103 · see citing works
Psoriasis and chronic obstructive pulmonary disease: a case-control study
Dreiher, J., Weitzman, D., Shapiro, J. S., Davidovici, B. B., & Cohen, A. D. (2008) · British Journal of Dermatology · doi:10.1111/j.1365-2133.2008.08749.x · Cited by 102 · see citing works
Nonalcoholic fatty liver disease in chronic obstructive pulmonary disease
Viglino, D., Jullian‐Desayes, I., Minovès, M., Aron‐Wisnewsky, J., Leroy, V., Zarski, J., Tamisier, R., Joyeux‐Faure, M., & Pépin, J. (2017) · European Respiratory Journal · doi:10.1183/13993003.01923-2016 · Cited by 98 · see citing works
Perez, T., Burgel, P., Paillasseur, J.-L., Caillaud, D. M., Deslée, G., Chanez, P., & Roche, N. (2015) · International Journal of COPD · doi:10.2147/copd.s82408 · Cited by 101 · see citing works
“For example, high rates of cardiovascular diseases (eg, chronic heart failure) and mood disorders (eg, anxiety and depression) have been reported in COPD patients 5,6 and suggested as contributing to dyspnea.”
Comorbidities and Systemic Effects of Chronic Obstructive Pulmonary Disease
Choudhury, G., Rabinovich, R., & MacNee, W. (2014) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2013.10.007 · Cited by 100 · see citing works
“Patients with COPD often have 1 or more components of the metabolic syndrome,(228) which are, at least in part, independent of treatment with steroids and/or physical inactivity.(229) Comorbidities and Systemic Effects of COPD 117”
Iyer, A. S., Bhatt, S. P., Garner, J. J., Wells, J. M., Trevor, J. L., Patel, N. M., Kirkpatrick, D., Williams, J. C., & Dransfield, M. T. (2015) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201507-439oc · Cited by 95 · see citing works
Earlier diagnosis and earlier treatment of COPD in primary care
Price, D. B., Freeman, D., Cleland, J., Kaplan, A. G., & Cerasoli, F. (2010) · Primary Care Respiratory Journal · doi:10.4104/pcrj.2010.00060 · Cited by 94 · see citing works
The Study to Understand Mortality and Morbidity in COPD (SUMMIT) study protocol
Vestbo, J., Anderson, J. A., Brook, R. D., Calverley, P. M. A., Celli, B. R., Crim, C. C., Haumann, B., Martínez, F. J., Yates, J., & Newby, D. E. (2012) · European Respiratory Journal · doi:10.1183/09031936.00087312 · Cited by 91 · see citing works
“It is increasingly recognized that COPD often coexists with other chronic diseases and that comorbidities can contribute to patients’ health status and prognosis [2, 3].”
BackgroundRecognition, diagnosis, and treatment of cognitive and psychiatric disorders in patients with COPD
Ouellette, D. R., & Lavoie, K. (2017) · International Journal of COPD · doi:10.2147/copd.s123994 · Cited by 87 · see citing works
“Patients with COPD are more likely to have coronary artery disease,(8,10) lung cancer,(11,12) metabolic syndrome,(13,14) osteoporosis,(15,16) diabetes mellitus,(8,17) and hypertension(8,18) than persons without COPD, resulting in some suggesting COPD be considered a multisystem inflammatory disorder rather than a cond…”
InfluentialMuscle and Blood Redox Status after Exercise Training in Severe COPD Patients
Rodriguez, D. A., Kalko, S., Puig-Vilanova, E., Perez-Olabarría, M., Falciani, F., Gea, J., Cascante, M., Barreiro, E., & Roca, J. (2012) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2011.09.022 · Cited by 102 · see citing works
McDonald, V. M., Simpson, J. L., Higgins, I. J., & Gibson, P. G. (2010) · Age and Ageing · doi:10.1093/ageing/afq134 · Cited by 88 · see citing works
Endothelial Dysfunction and Specific Inflammation in Obesity Hypoventilation Syndrome
Borel, J., Roux‐Lombard, P., Tamisier, R., Arnaud, C., Monneret, D., Arnol, N., Baguet, J.-P., Levy, P. A., & Pépin, J. (2009) · PLoS ONE · doi:10.1371/journal.pone.0006733 · Cited by 84 · see citing works
“Not only obesity but many other systemic diseases like diabetes, COPD, cardiovascular diseases or sleep apnea are associated with an underlying pro-inflammatory state [8,29,30].”
BackgroundSandelowsky, H., Weinreich, U. M., Aarli, B. B., Sundh, J., Høines, K. J., Stratelis, G., Løkke, A., Janson, C., Jensen, C., & Larsson, K. (2021) · BMC Family Practice · doi:10.1186/s12875-021-01583-w · Cited by 83 · see citing works
“age, smoking, systemic inflammation) or by one disease increasing the risk severity of the other [18, 141].”
BackgroundMAGNUSSEN, H., & Watz, H. (2009) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200906-053dp · Cited by 80 · see citing works
“The question arises whether systemic inflammation is the result of a spill-over of local inflammation to the systemic compartment or whether systemic inflammation might be a systemic component of COPD not necessarily related to the local inflammatory processes in the lung (2, 15, 16).”
BackgroundCoronary artery disease concomitant with chronic obstructive pulmonary disease
Roversi, S., Roversi, P., Spadafora, G., Rossi, R., & Fabbri, L. M. (2013) · European Journal of Clinical Investigation · doi:10.1111/eci.12181 · Cited by 81 · see citing works
Increased Sympathetic Nerve Activity in COPD is Associated with Morbidity and Mortality
Andreas, S., Haarmann, H., Klarner, S. F., Hasenfuss, G. P., & Raupach, T. (2013) · Lung · doi:10.1007/s00408-013-9544-7 · Cited by 79 · see citing works
“Although COPD primarily affects the lungs, it has recently become clear that systemic effects of COPD significantly contribute to its severity and overall mortality [1, 4].”
BackgroundBiomarkers in chronic obstructive pulmonary disease
Rosenberg, S. R., & Kalhan, R. (2012) · Translational research · doi:10.1016/j.trsl.2012.01.019 · Cited by 77 · see citing works
Controversies in treatment of chronic obstructive pulmonary disease
Rabe, K. F., & Wedzicha, J. A. (2011) · The Lancet · doi:10.1016/s0140-6736(11)61295-6 · Cited by 76 · see citing works
Burgel, P., Paillasseur, J.-L., & Roche, N. (2014) · BioMed Research International · doi:10.1155/2014/420134 · Cited by 76 · see citing works
“, diabetes, dyslipidemia, and metabolic syndrome), and cancer have been found highly prevalent among COPD patients [5, 6].”
BackgroundWhy Does Lung Function Predict Mortality? Results From the Whitehall II Cohort Study
Sabia, S., Shipley, M. J., Elbaz, A., Marmot, M. G., Mika Kivimaki, B., Kauffmann, F., & Singh‐Manoux, A. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwq294 · Cited by 76 · see citing works
Validity and Responsiveness of the Depression Anxiety Stress Scales-21 (DASS-21) in COPD
Yohannes, A. M., Dryden, S., & Hanania, N. A. (2018) · CHEST Journal · doi:10.1016/j.chest.2018.12.010 · Cited by 79 · see citing works
Network medicine, multimorbidity and the lung in the elderly
Faner, R., Cruz, T., López-Giraldo, A., & Agustí, A. G. N. (2014) · European Respiratory Journal · doi:10.1183/09031936.00078714 · Cited by 73 · see citing works
Koskela, J. T., Kilpeläinen, M., Kupiainen, H., Mazur, W., Sintonen, H., Boezen, M., Lindqvist, A. E., Postma, D. S., & Laitinen, T. (2014) · BMC Pulmonary Medicine · doi:10.1186/1471-2466-14-102 · Cited by 73 · see citing works
“and addiction diseases [1-5].”
The cardiopulmonary continuum systemic inflammation as ‘common soil’ of heart and lung disease
Ukena, C., Mahfoud, F., Kindermann, M., Kindermann, I., Bals, R., Voors, A. A., van Veldhuisen, D. J., & Böhm, M. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2010.04.082 · Cited by 73 · see citing works
Nakanishi, K., Takeda, Y., Tetsumoto, S., Iwasaki, T., Tsujino, K., Kuhara, H., Jin, Y., Nagatomo, I., Kida, H., Goya, S., et al. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201007-1091oc · Cited by 72 · see citing works
Electrocardiographic abnormalities and cardiac arrhythmias in chronic obstructive pulmonary disease
Goudis, C. A., Konstantinidis, A. K., Ntalas, I. V., & Korantzopoulos, P. G. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.06.096 · Cited by 72 · see citing works
“Thus, cardiovascular and pulmonary risk factors create a “cardiopulmonary continuum” through shared systemic inflammatory processes, inducing cascades of events which underpin chronic diseases including COPD, CAD, and HF [84,85].”
BackgroundExercise intolerance and systemic manifestations of pulmonary emphysema in a mouse model
Lüthje, L., Raupach, T., Michels, H., Unsöld, B. W., Hasenfuss, G. P., Kögler, H., & Andreas, S. (2009) · Respiratory Research · doi:10.1186/1465-9921-10-7 · Cited by 72 · see citing works
“Although COPD affects primarily the lungs it recently became clear that systemic effects of COPD significantly contribute to its severity and mortality [1,6].”
BackgroundNatural Histories of Chronic Obstructive Pulmonary Disease
Rennard, S. I., & Vestbo, J. (2008) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200804-035qc · Cited by 72 · see citing works
The diagnosis and treatment of COPD and its comorbidities
Kahnert, K., Jörres, R. A., Behr, J., & Welte, T. (2023) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2023.0027 · Cited by 204 · see citing works
Clinical relevance of plasma miR-106b levels in patients with chronic obstructive pulmonary disease
Soeda, S., Ohyashiki, J. H., Ohtsuki, K., Umezu, T., Setoguchi, Y., & Ohyashiki, K. (2013) · International Journal of Molecular Medicine · doi:10.3892/ijmm.2013.1251 · Cited by 70 · see citing works
Fruchter, O., Yigla, M., & Kramer, M. R. (2014) · The American Journal of the Medical Sciences · doi:10.1097/maj.0000000000000332 · Cited by 70 · see citing works
Fabbri, L. M., Boyd, C. M., Boschetto, P., Rabe, K. F., Buist, A. S., Yawn, B. P., Leff, B. A., Kent, D. M., & Schünemann, H. J. (2012) · Proceedings of the American Thoracic Society · doi:10.1513/pats.201208-063st · Cited by 70 · see citing works
Kerley, C. P., Cahill, K., Bolger, K., McGowan, A., Burke, C., Faul, J., & Cormican, L. (2015) · Nitric Oxide · doi:10.1016/j.niox.2014.12.010 · Cited by 69 · see citing works
Marco, E., Sánchez‐Rodríguez, D., Dávalos‐Yerovi, V., Durán, X., Pascual, E. M., Muniesa, J. M., Rodriguez, D. A., Aguilera-Zubizarreta, A., Escalada, F., & Duarte, E. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2018.09.014 · Cited by 69 · see citing works
COPD and the metabolic syndrome: an intriguing association
Clini, E. M., Crisafulli, E., Radaeli, A., & Malerba, M. (2011) · Internal and Emergency Medicine · doi:10.1007/s11739-011-0700-x · Cited by 67 · see citing works
“decade, however, it has been increasingly recognized that the presence of common factors in COPD and in other chronic extra-pulmonary diseases, together with the frequent co-existence of these conditions in the same adult individual, supports the hypothesis of a common process sharing their pathogenesis in the same pa…”
BackgroundB-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review
Hawkins, N. M., Khosla, A., Virani, S., McMurray, J. J. V., & FitzGerald, J. M. (2017) · BMC Pulmonary Medicine · doi:10.1186/s12890-016-0345-7 · Cited by 67 · see citing works
“Many of these factors are present in stable COPD and common non-infective precipitants of exacerbation [32, 41, 63].”
BackgroundComorbidity in chronic obstructive pulmonary disease
Negewo, N. A., McDonald, V. M., & Gibson, P. G. (2015) · Respiratory Investigation · doi:10.1016/j.resinv.2015.02.004 · Cited by 66 · see citing works
“Clinical decision making is further complicated by the lack of adequate recommendations in the existing guidelines regarding the management of COPD patients, who may also suffer from other comorbid conditions [103].”
BackgroundManagement of the COPD Patient with Comorbidities: An Experts Recommendation Document
Iglesias, J. R., Díez‐Manglano, J., Garcı́a, F. L., Peromingo, J. A. D., Almagro, P., & Aguilar, J. M. V. (2020) · International Journal of COPD · doi:10.2147/copd.s242009 · Cited by 74 · see citing works
Young, R. P., Hopkins, R. J., & Eaton, T. E. (2009) · Postgraduate Medical Journal · doi:10.1136/pgmj.2008.078477 · Cited by 64 · see citing works
Ställberg, B., Janson, C., Larsson, K., Johansson, G. S., Κostikas, Κ., Gruenberger, J.-B., Gutzwiller, F. S., Jørgensen, L., Uhde, M., & Lisspers, K. (2018) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-018-0101-y · Cited by 64 · see citing works
- Authors
- Fabbri, L. M., Luppi, F., Beghé, B., & Rabe, K. F.
- Affiliations
- University of Modena and Reggio Emilia (IT)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2007-12-31
- Volume
- 31
- Issue
- 1
- Pages
- 204-212
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2165340553
- Cited by
- 660
- References
- 139
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 20 · 2023: 17 · 2022: 26 · 2021: 19 · 2020: 35 · 2019: 25 · 2018: 36 · 2017: 48 · 2016: 31 · 2015: 50 · 2014: 68 · 2013: 55 · 2012: 59
- FWCI
- 28.24
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- cc-by
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- chronic obstructive pulmonary disease, comorbidities, systemic inflammation, chronic heart failure, metabolic syndrome, cigarette smoking, C-reactive protein, inflammatory markers, COPD severity assessment, cardiovascular function, COPD management
- MeSH terms
- Chronic Disease, Health Status, Humans, Inflammation, Lung, Models, Biological, Prognosis, Risk Factors, Smoking, Pulmonary Medicine, Comorbidity, Guidelines as Topic, Pulmonary Disease, Chronic Obstructive, Overweight
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