Marin, J.M. (José M.)
- Publications
- item.page.relationships.isContributorAdvisorOfPublication
- item.page.relationships.isContributorOfPublication
17 results
Search Results
Now showing 1 - 10 of 17
- Clinical and prognostic impact of low diffusing capacity for carbon monoxide values in patients with global initiative for obstructive lung disease I COPD(2021) Cabrera, C. (Carlos); Cosio, B.G. (Borja G.); Martinez-Gonzalez, C. (Cristina); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Marin, J.M. (José M.); Gonzalez-Gutierrez, J. (Jessica); Torres, J.P. (Juan P.) de; Fuster, A. (Antonia); Ezponda, A. (Ana); Solanes-García, I. (Ingrid); Marin-Marin, M. (Marta); O'Donnell, D.E. (Denis E.); Neder, J.A. (J. Alberto)Background The Global Initiative for Obstructive Lung Disease (GOLD) does not promote diffusing capacity for carbon monoxide (Dlco) values in the evaluation of COPD. In GOLD spirometric stage I COPD patients, the clinical and prognostic impact of a low Dlco has not been explored. Research Question Could a Dlco threshold help define an increased risk of death and a different clinical presentation in these patients? Study Design and Methods GOLD stage I COPD patients (n = 360) were enrolled and followed over 109 ± 50 months. Age, sex, pack-years’ history, BMI, dyspnea, lung function measurements, exercise capacity, BODE index, and history of exacerbations were recorded. A cutoff value for Dlco was identified for all-cause mortality and the clinical and physiological characteristics of patients above and below the threshold compared. Cox regression analysis explored the predictive power of that cutoff value for all-cause mortality. Results A Dlco cutoff value of <60% predicted was associated with all-cause mortality (Dlco ≥ 60%: 9% vs Dlco < 60%: 23%, P = .01). At a same FEV1% predicted and Charlson score, patients with Dlco < 60% had lower BMI, more dyspnea, lower inspiratory capacity (IC)/total lung capacity (TLC) ratio, lower 6-min walk distance (6MWD), and higher BODE. Cox multiple regression analysis confirmed that after adjusting for age, sex, pack-years history, smoking status, and BMI, a Dlco < 60% is associated with all-cause mortality (hazard ratio [HR], 95% CI = 3.37, 1.35-8.39; P = .009) Interpretation In GOLD I COPD patients, a Dlco < 60% predicted is associated with increased risk of death and worse clinical presentation. What the cause(s) of this association are and whether they can be treated need to be determined.
- Large-scale external validation and comparison of prognostic models: an application to chronic obstructive pulmonary disease(2018) Sobradillo, P. (Patricia); Haile, S.R. (Sara R.); Esteban, C. (Cristóbal); 3CIA collaboration; Cosio, B.G. (Borja G.); Johannessen, A. (Ane); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Han, M.K. (Meilan K.); Ramirez, A.S. (Ana S.); Burgel, P.R.(Pierre-Régis); Soler-Cataluña, J.J. (Juan José); Lamprecht, B. (Bernd); Turner, A.M. (Alice M.); Ancochea-Bermúdez, J. (Julio); García-Aymerich, J. (Judith); Marin, J.M. (José M.); Langhammer, A. (Arnulf); Oga, T. (Toru); Almagro, P. (Pere); Torres, J.P. (Juan P.) de; Soriano, J.B. (Joan B.); Bakke, P. (Per); Guerra, B. (Beniamino); Roche, N. (Nicolás); Martinez-Camblor, P. (Pablo); Leivseth, L. (Linda); Miravitlles, M. (Marc); Antó, J.M. (Josep M.); Lange, P. (Peter); Echazarreta, A. (Andrés); Puhan, M.A. (Milo A.); Kaiser, B. (Bernhard); Alfageme, I. (Inmaculada); Sin, D.D. (Don D.); Riet, G. (Gerben) terBackground: External validations and comparisons of prognostic models or scores are a prerequisite for their use in routine clinical care but are lacking in most medical fields including chronic obstructive pulmonary disease (COPD). Our aim was to externally validate and concurrently compare prognostic scores for 3-year all-cause mortality in mostly multimorbid patients with COPD. Methods: We relied on 24 cohort studies of the COPD Cohorts Collaborative International Assessment consortium, corresponding to primary, secondary, and tertiary care in Europe, the Americas, and Japan. These studies include globally 15,762 patients with COPD (1871 deaths and 42,203 person years of follow-up). We used network meta-analysis adapted to multiple score comparison (MSC), following a frequentist two-stage approach; thus, we were able to compare all scores in a single analytical framework accounting for correlations among scores within cohorts. We assessed transitivity, heterogeneity, and inconsistency and provided a performance ranking of the prognostic scores. Results: Depending on data availability, between two and nine prognostic scores could be calculated for each cohort. The BODE score (body mass index, airflow obstruction, dyspnea, and exercise capacity) had a median area under the curve (AUC) of 0.679 [1st quartile-3rd quartile = 0.655-0.733] across cohorts. The ADO score (age, dyspnea, and airflow obstruction) showed the best performance for predicting mortality (difference AUC(ADO) - AUC(BODE) = 0.015 [95% confidence interval (CI) = - 0.002 to 0.032]; p = 0.08) followed by the updated BODE (AUCBODE updated - AUCBODE = 0.008 [95% CI = -0.005 to +0.022]; p = 0.23). The assumption of transitivity was not violated. Heterogeneity across direct comparisons was small, and we did not identify any local or global inconsistency. Conclusions: Our analyses showed best discriminatory performance for the ADO and updated BODE scores in patients with COPD. A limitation to be addressed in future studies is the extension of MSC network meta-analysis to measures of calibration. MSC network meta-analysis can be applied to prognostic scores in any medical field to identify the best scores, possibly paving the way for stratified medicine, public health, and research.
- Impact of applying the global lung initiative criteria for airway obstruction in GOLD defined COPD cohorts: the BODE and CHAIN experience(2024) Cabrera, C. (Carlos); Cosio, B.G. (Borja G.); Bastarrika, G. (Gorka); Celli, B.R. (Bartolomé R.); Gotera-Rivera, C. (Carolina); Casanova, C. (Ciro); Sangro, M. (Matilde); Marin, J.M. (José M.); Torres, J.P. (Juan P.) de; Fuster, A. (Antonia); Alcaide, A.B. (Ana Belén); Ezponda, A. (Ana); Solanes-García, I. (Ingrid); Feu-Collado, N. (Nuria); Marin-Marin, M. (Marta); Martínez, C. (Cristina); Calle, M. (Myriam); Marin, A. (Alicia); Peces-Barba, G. (German)Introduction: The Global Lung Function Initiative (GLI) has proposed new criteria for airflow limitation (AL) and recommends using these to interpret spirometry. The objective of this study was to explore the impact of the application of the AL GLI criteria in two well characterized GOLD-defined COPD cohorts. Methods: COPD patients from the BODE (n=360) and the COPD History Assessment In SpaiN (CHAIN) cohorts (n=722) were enrolled and followed. Age, gender, pack-years history, BMI, dyspnea, lung function measurements, exercise capacity, BODE index, history of exacerbations and survival were recorded. CT-detected comorbidities were registered in the BODE cohort. The proportion of subjects without AL by GLI criteria was determined in each cohort. The clinical, CT-detected comorbidity, and overall survival of these patients were evaluated. Results: In total, 18% of the BODE and 15% of the CHAIN cohort did not meet GLI AL criteria. In the BODE and CHAIN cohorts respectively, these patients had a high clinical burden (BODE≥3: 9% and 20%; mMRC≥2: 16% and 45%; exacerbations in the previous year: 31% and 9%; 6MWD<350m: 15% and 19%, respectively), and a similar prevalence of CT-diagnosed comorbidities compared with those with GLI AL. They also had a higher rate of long-term mortality - 33% and 22% respectively. Conclusions: An important proportion of patients from 2 GOLD-defined COPD cohorts did not meet GLI AL criteria at enrolment, although they had a significant burden of disease. Caution must be taken when applying the GLI AL criteria in clinical practice.
- Natural course of the diffusing capacity of the lungs for carbon monoxide in COPD: importance of sex(2021) Cabrera, C. (Carlos); Cosio, B.G. (Borja G.); Martinez-Gonzalez, C. (Cristina); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Divo, M. (Miguel); Marín-Oto, M. (Marta); Marin, J.M. (José M.); Ojeda, E. (Elena); Torres, J.P. (Juan P.) de; Fuster, A. (Antonia); Solanes-García, I. (Ingrid); Feu-Collado, N. (Nuria); Balcells, E. (Eva); González-Dávila, E. (Enrique); Pinto-Plata, V. (Víctor); Golpe, R. (Rafael); Amado, C. (Carlos); Calle, M. (Myriam); Lopez-Campos, J.L. (José Luis); Peces-Barba, G. (German)Background: The value of the single-breath diffusing capacity of the lungs for carbon monoxide (Dlco) relates to outcomes for patients with COPD. However, little is known about the natural course of Dlco over time, intersubject variability, and factors that may influence Dlco progression. Research question: What is the natural course of Dlco in patients with COPD over time, and which other factors, including sex differences, could influence this progression? Study design and methods: We phenotyped 602 smokers (women, 33%), of whom 506 (84%) had COPD and 96 (16%) had no airflow limitation. Lung function, including Dlco, was monitored annually over 5 years. A random coefficients model was used to evaluate Dlco changes over time. Results: The mean (± SE) yearly decline in Dlco % in patients with COPD was 1.34% ± 0.015%/y. This was steeper compared with non-COPD control subjects (0.04% ± 0.032%/y; P = .004). Sixteen percent of the patients with COPD, vs 4.3% of the control subjects, had a statistically significant Dlco % slope annual decline (4.14%/y). At baseline, women with COPD had lower Dlco values (11.37% ± 2.27%; P < .001) in spite of a higher FEV1 % than men. Compared with men, women with COPD had a steeper Dlco annual decline of 0.89% ± 0.42%/y (P = .039). Interpretation: Patients with COPD have an accelerated decline in Dlco compared with smokers without the disease. However, the decline is slow, and a testing interval of 3 to 4 years may be clinically informative. The lower and more rapid decline in Dlco values in women, compared with men, suggests a differential impact of sex in gas exchange function. Trial registry: ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov.
- Metallomic signatures of lung cancer and chronic obstructive pulmonary disease(2023) Santana, R. (Rafael); Gotera-Rivera, C. (Carolina); Marin, J.M. (José M.); Sánchez-Espirilla, S. (Saida); García-Cosio, B. (Borja); Díaz-Olivares, I. (Isabel); Callejón-Leblic, B. (Belén); Fuster, A. (Antonia); Solanes-García, I. (Ingrid); Casanova-Macario, C. (Ciro)Lung cancer (LC) is the leading cause of cancer deaths, and chronic obstructive pulmonary disease (COPD) can increase LC risk. Metallomics may provide insights into both of these tobacco-related diseases and their shared etiology. We conducted an observational study of 191 human serum samples, including those of healthy controls, LC patients, COPD patients, and patients with both COPD and LC. We found 18 elements (V, Al, As, Mn, Co, Cu, Zn, Cd, Se, W, Mo, Sb, Pb, Tl, Cr, Mg, Ni, and U) in these samples. In addition, we evaluated the elemental profiles of COPD cases of varying severity. The ratios and associations between the elements were also studied as possible signatures of the diseases. COPD severity and LC have a significant impact on the elemental composition of human serum. The severity of COPD was found to reduce the serum concentrations of As, Cd, and Tl and increased the serum concentrations of Mn and Sb compared with healthy control samples, while LC was found to increase Al, As, Mn, and Pb concentrations. This study provides new insights into the effects of LC and COPD on the human serum elemental profile that will pave the way for the potential use of elements as biomarkers for diagnosis and prognosis. It also sheds light on the potential link between the two diseases, i.e., the evolution of COPD to LC.
- New GOLD classification: longitudinal data on group assignment(BioMed Central, 2014) Ramos, P. (Pilar); Galdiz, J.B. (Juan Bautista); Cosio, B.G. (Borja G.); Martinez-Gonzalez, C. (Cristina); Casanova, C. (Ciro); Soler-Cataluña, J.J. (Juan José); Agüero, R. (Ramón); Marin, J.M. (José M.); Calle-Rubio, M. (Miryam); Marin, M. (Margarita); Torres, J.P. (Juan P.) de; Irigaray, R. (Rosa); Soriano, J.B. (Joan B.); Diego-Damia, A. (Alfredo) de; Solanes-García, I. (Ingrid); Feu-Collado, N. (Nuria); Balcells, E. (Eva); Llunell, A. (Antonia); Lopez-Campos, J.L. (José Luis); Alfageme, I. (Inmaculada); Mir-Viladrich, I. (Isabel); Peces-Barba, G. (German)In the new GOLD grading classification, the type of tool used to determine the level of symptoms can substantially alter the group assignment. A change in category after one year was associated with longitudinal changes in the CAT and BODE index.
- Sex differences in mortality in patients with COPD(European Respiratory Society, 2009) Oca, M.M. (M.M.) de; Nekach, V. (V.); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Cote, C.G. (C.G.); Marin, J.M. (José M.); Torres, J.P. (Juan P.) de; Aguirre-Jaime, A. (Armando); Lopez, M.V. (M.V.); Diaz, O. (O.); Pinto-Plata, V. (Víctor); Dordelly, L.J. (L. J.)Little is known about survival and clinical prognostic factors in females with chronic obstructive pulmonary disease (COPD). The aim of the present study was to determine the survival difference between males and females with COPD and to compare the value of the different prognostic factors for the disease. In total, 265 females and 272 males with COPD matched at baseline by BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) and American Thoracic Society/European Respiratory Society/Global Initiative of Chronic Obstructive Lung Disease criteria were prospectively followed. Demographics, lung function, St George’s Respiratory Questionnaire, BODE index, the components of the BODE index and comorbidity were determined. Survival was documented and sex differences were determined using Kaplan–Meier analysis. The strength of the association of the studied variables with mortality was determined using multivariate and receiver operating curves analysis. All-cause (40 versus 18%) and respiratory mortality (24 versus 10%) were higher in males than females. Multivariate analysis identified the BODE index in females and the BODE index and Charlson comorbidity score in males as the best predictors of mortality. The area under the curve of the BODE index was a better predictor of mortality than the forced expiratory volume in one second for both sexes. At similar chronic obstructive pulmonary disease severity by BODE index and forced expiratory volume in one second, females have significantly better survival than males. For both sexes the BODE index is a better predictor of survival than the forced expiratory volume in one second.
- Long term management of obstructive sleep apnea and its comorbidities(PAGEPress Publications, 2019) Marín-Oto, M. (Marta); Marin, J.M. (José M.); Vicente, E.E. (Eugenio E.)Obstructive sleep apnea (OSA) is a worldwide highly prevalent disease associated with systemic consequences, including excessive sleepiness, impairment of neurocognitive function and daytime performance, including driving ability. The long-term sequelae of OSA include and increase risk for cardiovascular, cerebrovascular and metabolic syndrome disorders that ultimately lead to premature death if untreated. To ensure optimal long-term outcomes, the assessment and management of OSA should be personalized with the involvement of the appropriate specialist. Most studies have demonstrated inmediate improvement in daytime somnolence and quality of life with CPAP and other therapies, but the effect of long-term treatment on mortality is still under debate. Currently, the long-term management of OSA should be based on a) identifying physiological or structural abnormalities that are treatable at the time of patient evaluation and b) comprehensive lifestyle interventions, especially weight-loss interventions, which are associated with improvements in OSA severity, cardiometabolic comorbidities, and quality of life. In long-term management, attention should be paid to the clinical changes related to a potential reoccurrence of OSA symptoms and it is also necessary to monitor throughout the follow up how the main associated comorbidities evolve.
- Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2015 and GOLD 2019 staging: a pooled analysis of individual patient data(European respiratory society, 2020) Sobradillo, P. (Patricia); Sternberg, A. (Alice); Esteban, C. (Cristóbal); Navarro, A. (Annie); Cosio, B.G. (Borja G.); Johannessen, A. (Ane); García-Castillo, E. (Elena); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Han, M.K. (Meilan K.); Burgel, P.R.(Pierre-Régis); Soler-Cataluña, J.J. (Juan José); Ramírez-García-Luna, A.S. (Ana S.); Lamprecht, B. (Bernd); Turner, A.M. (Alice M.); Ancochea-Bermúdez, J. (Julio); García-Aymerich, J. (Judith); Marin, J.M. (José M.); Langhammer, A. (Arnulf); Oga, T. (Toru); Almagro, P. (Pere); Torres, J.P. (Juan P.) de; Soriano, J.B. (Joan B.); Carrasco, L. (Laura); Bakke, P. (Per); Alonso-Pérez, T. (Tamara); Roche, N. (Nicolás); Aalberg-Vikjord, S.A. (Sigrid Ana); Martinez-Camblor, P. (Pablo); Leivseth, L. (Linda); Miravitlles, M. (Marc); Pastor-Sanz, M.T. (Maria Teresa); Antó, J.M. (Josep M.); Lange, P. (Peter); Echazarreta, A. (Andrés); Puhan, M.A. (Milo A.); Kaiser, B. (Bernhard); Lopez-Campos, J.L. (José Luis); Alfageme, I. (Inmaculada); Sin, D.D. (Don D.); Rodríguez-Carballeira, M. (Mónica); Riet, G. (Gerben) terIn 2019, The Global Initiative for Chronic Obstructive Lung Disease (GOLD) modified the grading system for patients with COPD, creating 16 subgroups (1A–4D). As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aim to compare the mortality prediction of the 2015 and 2019 COPD GOLD staging systems. We studied 17 139 COPD patients from the 3CIA study, selecting those with complete data. Patients were classified by the 2015 and 2019 GOLD ABCD systems, and we compared the predictive ability for 5-year mortality of both classifications. In total, 17 139 patients with COPD were enrolled in 22 cohorts from 11 countries between 2003 and 2017; 8823 of them had complete data and were analysed. Mean±sd age was 63.9±9.8 years and 62.9% were male. GOLD 2019 classified the patients in milder degrees of COPD. For both classifications, group D had higher mortality. 5-year mortality did not differ between groups B and C in GOLD 2015; in GOLD 2019, mortality was greater for group B than C. Patients classified as group A and B had better sensitivity and positive predictive value with the GOLD 2019 classification than GOLD 2015. GOLD 2015 had better sensitivity for group C and D than GOLD 2019. The area under the curve values for 5-year mortality were only 0.67 (95% CI 0.66–0.68) for GOLD 2015 and 0.65 (95% CI 0.63–0.66) for GOLD 2019.
- Chest CT-assessed comorbidities and all-cause mortality risk in COPD patients in the BODE cohort(Wiley, 2022) Bastarrika, G. (Gorka); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Divo, M. (Miguel); Martin-Palmero, A. (Ángela); Marín-Oto, M. (Marta); Marin, J.M. (José M.); Polverino, F. (Francesca); Torres, J.P. (Juan P.) de; Ezponda, A. (Ana); Pinto-Plata, V. (Víctor)Abstract Background and objective: The availability of chest computed tomography (CT) imaging can help diagnose comorbidities associated with chronic obstructive pulmonary disease (COPD). Their systematic identification and relationship with allcause mortality have not been explored. Furthermore, whether their CT-detected prevalence differs from clinical diagnosis is unknown. Methods: The prevalence of 10 CT-assessed comorbidities was retrospectively determined at baseline in 379 patients (71% men) with mild to severe COPD attending pulmonary clinics. Anthropometrics, smoking history, dyspnoea, lung function, exercise capacity, BODE (BMI, Obstruction, Dyspnoea and Exercise capacity) index and exacerbations rate were recorded. The prevalence of CT-determined comorbidities was compared with that recorded clinically. Over a median of 78 months of observation, the independent association with all-cause mortality was analysed. A ‘CT-comorbidome’ graphically expressed the strength of their association with mortality risk. Results: Coronary artery calcification, emphysema and bronchiectasis were the most prevalent comorbidities (79.8%, 62.7% and 33.9%, respectively). All were underdiagnosed before CT. Coronary artery calcium (hazard ratio [HR] 2.09; 95% CI 1.03–4.26, p = 0.042), bronchiectasis (HR 2.12; 95% CI 1.05–4.26, p = 0.036) and low psoas muscle density (HR 2.61; 95% CI 1.23–5.57, p = 0.010) were independently associated with all-cause mortality and helped define the ‘CT-comorbidome’. Conclusion: This study of COPD patients shows that systematic detection of 10 CT-diagnosed comorbidities, most of which were not detected clinically, provides information of potential use to patients and clinicians caring for them.