Abstract
Background:The overlap between asthma and chronic obstructive pulmonary disease (COPD) is an important clinical phenomenon. However, the prevalence of asthma–COPD overlap syndrome (ACOS) is not known.Aims:To investigate the prevalence of ACOS among asthmatic patients with a smoking history, and evaluate the factors predicting ACOS in this patient group.Methods:We investigated 190 primary care asthma patients with no previous diagnosis of COPD, but who were either current or ex-smokers, with a smoking history of at least 10 pack-years. Spirometry was performed on all the patients while they were taking their normal asthma medication. Patients were considered to have ACOS if their postbronchodilator forced expiratory volume in 1 s/forced vital capacity was <0.70.Results:Fifty-two (27.4%) of the patients were found to have ACOS. Age ⩾60 years and smoking for ⩾20 pack-years were the best predictors of ACOS. If both of these criteria were met, the odds ratio (95% confidence interval) for ACOS was 6.08 (2.11–17.49), compared with the situation where neither of these criteria were fulfilled.Conclusions:There is a high prevalence of ACOS among primary health care asthmatics with a positive smoking history but no previous diagnosis of COPD. In this population, age over 60 years and a smoking history of more than 20 pack-years were the best predictors of ACOS.
Highlights
Asthma and chronic obstructive pulmonary disease (COPD) are the two most common obstructive pulmonary diseases
A recent update of the GINA report recommended a stepwise approach to the diagnosis of asthma–COPD overlap syndrome (ACOS), and defined it as a syndrome characterized by persistent airflow limitation with several features usually associated with asthma and several features usually associated with COPD.1
Main findings We found the prevalence of asthma–COPD overlap syndrome to be 27.4% among primary health care asthmatics with no previous diagnosis of COPD, but who were either current or ex-smokers with a smoking history of at least 10 pack-years
Summary
Asthma and chronic obstructive pulmonary disease (COPD) are the two most common obstructive pulmonary diseases. The definition of asthma–COPD overlap syndrome (ACOS) is undetermined Most commonly, it is defined as either the diagnosis of COPD in a patient with previously diagnosed asthma, or as incompletely reversible airway obstruction accompanied by symptoms or signals of increased reversibility of the obstruction.. METHODS: We investigated 190 primary care asthma patients with no previous diagnosis of COPD, but who were either current or ex-smokers, with a smoking history of at least 10 pack-years. CONCLUSIONS: There is a high prevalence of ACOS among primary health care asthmatics with a positive smoking history but no previous diagnosis of COPD. In this population, age over 60 years and a smoking history of more than 20 pack-years were the best predictors of ACOS
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