Source: International Congress 2014 – Longitudinal studies of respiratory disease
Disease area: Airway diseases

Abstract

Rationale: There is evidence from high-income countries that low lung function and COPD predict subsequent mortality. Little is known about lung function as predictors of mortality in low- and middle income countries. Aims: To describe mortality rates according to COPD and lung function in cohorts from three Latin American (LA) cities. Methods: Prospective population based adult cohorts were followed up in Montevideo, Santiago and Sao Paulo during 5, 6 and 9 years, respectively. The outcomes included all-cause, cardiovascular, respiratory and cancer mortality; exposures were COPD (according to different criteria), FEV₁ and FVC. Cox regression models were used in confounder-adjusted analyses. Sensitivity, specificity, positive and negative predictive values, ROC curves and Youden's index were calculated. Results: The main causes of death were cardiovascular, respiratory and cancer. In the adjusted models, baseline COPD was associated with overall mortality (HR 1.43 for FEV1/FVC<LLN, 2.01 for GOLD 2-4, 1.46 for the fixed ratio (FEV₁/FVC<0.7) and 1.50 for FEV₁/FEV₆<LLN). For cardiovascular mortality, significant associations were found with GOLD 2-4 (HR 2.68) and with the fixed ratio (HR 1.78) for both sexes together but not among women. Low FEV₁ was associated with an increased risk for overall and respiratory mortality in both sexes. FVC did not show a significant association with overall mortality. For most COPD criteria sensitivity was lower than specificity. The area under the curve for FEV₁ was greater than for FVC for overall and cardiovascular mortality. Conclusions: COPD and low FEV₁ are important predictors for overall and cardiovascular mortality in LA.

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A. M. B. Menezes, R. Perez-Padilla, F. C. Wehrmeister, M. V. Lopez-Varela, A. Muiño, G. Valdivia, C. Lisboa, J. R. Jardim, M. Montes de Oca, C. Talamo, R. Bielemann, M. Gazzotti, R. Laurentu, B. Celli, C. Victora (Pelotas, Sao Paulo, Brazil; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; Caracas, Venezuela; Boston, United States Of America). CPOD and lung function parameters as predictors of mortality: Results from the Latin American PLATINO cohort study. Eur Respir J 2014; 44: Suppl. 58, 2980

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