Background: Factors influencing the decline in forced expiratory volume in one second (FEV₁)/forced vital capacity (FVC) for chronic obstructive pulmonary disease (COPD) progression remain uncertain. We aimed to identify risk factors associated with rapid FEV₁/FVC decline in patients with COPD.
Methods: This multi-center observational study was conducted from January 2012 to December 2022. Eligible patients were monitored with symptoms, spirometric tests, and treatment patterns over 3 years. Rapid FEV₁/FVC decliners were defined as the quartile of patients exhibiting the highest annualized percentage decline in FEV₁/FVC.
Results: Among 1,725 patients, 435 exhibited rapid FEV₁/FVC decline, with an annual change of -2.5%p (interquartile range, -3.5 to -2.0). Rapid FEV₁/FVC decliners exhibited lower body mass index (BMI), higher smoking rates, elevated post-bronchodilator (BD) FEV₁, higher post-BD FEV₁/FVC, and a lower prevalence of Staging of Airflow Obstruction by Ratio (STAR) stage IV. Rapid FEV₁/FVC decline was not linked to the annual exacerbation rate, but there was an association with symptom deterioration and FEV₁ decline. In multivariable analyses, low BMI, current smoking, increased modified Medical Research Council dyspnoea score, low post-BD FEV₁, low STAR stage, high forced mid-expiratory flow (FEF), accelerated FEV₁ decline, and not initiating dual BD therapy were identified as independent risk factors for rapid FEV₁/FVC decline.
Conclusion: We identified the risk factors for rapid FEV₁/FVC decline, including BMI, smoking, symptoms deterioration, FEV₁ decline, and adherence to standard inhaler treatment. Our findings underscore the potential benefits of maintaining consistent use of long-acting beta-agonist/long-acting muscarinic antagonist even in the presence of worsening symptoms, in attenuating FEV₁/FVC decline.
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| http://dx.doi.org/10.3346/jkms.2025.40.e32 | DOI Listing |
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Article Synopsis
- The study investigates the link between lung function decline (measured by FEV1 and FVC) and the risk of developing cardiovascular diseases (CVD) among 29,662 participants from the UK Biobank who were free of CVD at the start.
- It defines rapid lung function decline as significant decreases in FEV1 or FVC, and analyzes the associations with different types of CVD using statistical models.
- Results indicate that a rapid decline in lung function is significantly associated with increased risk for various CVDs, highlighting the importance of monitoring lung health as a potential preventive measure for heart-related issues.
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