Browse ATS 2021 Abstracts

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ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.

Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.

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The Influence of Chronic Bronchitis Status on Lung Function Decline: An Analysis of the COPDGene Cohort

Session Title
TP41 - TP041 DIAGNOSIS AND RISK ASSESSMENT IN COPD
Abstract
A2290 - The Influence of Chronic Bronchitis Status on Lung Function Decline: An Analysis of the COPDGene Cohort
Author Block: V. Kim1, M. K. Han2, B. J. Make3, J. D. Crapo4, J. L. Curtis5, E. K. Silverman6, S. P. Bhatt7, G. J. Criner1, M. Strand8, D. L. DeMeo6; 1Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States, 2University of Michigan, Ann Arbor, MI, United States, 3Natl Jewish Health, Denver, CO, United States, 4National Jewish Health, Denver, CO, United States, 5Internal Medicine, Univ of Michigan Hlth System, Ann Arbor, MI, United States, 6Brigham and Womens Hosp, Boston, MA, United States, 7Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, United States, 8Pulmonary and Critical Care Medicine, National Jewish Health, Denver, CO, United States.
Introduction: Chronic bronchitis (CB) has previously been associated with an accelerated rate of lung function decline. However, CB is not a permanent condition; it may resolve in some and newly develop in others irrespective of smoking status. The effects of waxing or waning CB on lung function decline are unknown. We hypothesized that those with persistent CB or newly developed CB would have a greater rate of lung function decline compared to those without CB or with resolved CB. Methods: We studied 1869 current and former smokers with or without COPD (including Preserved Ratio but Impaired Spirometry [PRISm]) from the COPDGene study who had spirometry at baseline, 5 years, and 10 years. Subjects were divided into four groups based on presence or absence of CB (classic definition, chronic cough and phlegm for at least 3 months/year for 2 consecutive years) at baseline and then at the 5 year visit: Persistent CB(-) [CB(-) baseline and 5 years], Resolved CB [CB(+) baseline, (-) 5 years], New CB [CB(-) baseline, (+) 5 years], and Persistent CB(+) [CB(+) baseline and 5 years]. We compared the annual rate of FEV1 decline averaged over 10 years between groups using one-way ANOVA, and to assess the independent effects of CB status on FEV1 decline, performed multivariable linear regression adjusted for baseline lung function, smoking history, current smoking, age, sex, and height. Results: The annualized rate of FEV1 decline over 10 years did not differ between the Resolved CB (n=160) and Persistent CB(-) groups (n=1463) (mean difference -4.99 mL/year, 95% CI -12.29, 2.32, p=0.43) (Figure 1). By contrast, both New CB (n=129) and Persistent CB(+) (n=117) had significantly greater FEV1 decline compared to Persistent CB(-) [mean differences -12.53 mL/year, 95% CI -20.59, -4.47, p<0.0001 for New CB; and -9.73 mL/year, 95% CI -18.16, -1.3, p=0.014 for Persistent CB(+)]. CB status was independently associated with FEV1 decline (Beta coeff -4.28, SE 0.88, p<0.0001). Conclusions: Compared to those without CB, persistence of CB over 5 years or its new development are associated with a faster loss of lung function regardless of smoking status, with the greatest decline in New CB. Subjects whose CB resolves have the same rate of lung function decline as those who never had CB. These data support targeting CB as a means of improving COPD outcomes.