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- Parker, W. A. E., et al.
(författare)
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Prevalence of microspirometry-defined chronic obstructive pulmonary disease in two European cohorts of patients with significant smoking history hospitalised for acute myocardial infarction
- 2023
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Ingår i: Thorax. - : BMJ Publishing Group Ltd. - 0040-6376 .- 1468-3296. ; 78:Suppl. 4, s. A66-A66
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Smoking is a major risk factor for both chronic obstructive pulmonary disease (COPD) and myocardial infarction (MI). Systemic inflammation also contributes to both diseases and has been suggested as a potential target for intervention. Prevalence of COPD in those with a significant smoking history hospitalised for MI has not been well-characterised. We sought to obtain an accurate estimate of COPD burden in this group and characterise the population.Methods: Two consecutive cohorts of patients hospitalised for MI with a smoking history of ≥10 pack-years were recruited in Sweden and the United Kingdom (UK). Baseline characteristics were recorded, including treatment with inhaled corticosteroids (ICS) and eosinophil count in blood. Microspirometry was performed using the Vitalograph COPD-6 device and symptom burden assessed using the COPD Assessment Test (CAT). The primary outcome was the prevalence of a preliminary diagnosis of clinically-significant COPD, here defined as a ratio of forced expiratory volume in 1 and 6 seconds (FEV1/FEV6) <0.7 and with FEV1 <80% of predicted value.Results: In the UK cohort, 216 participants with MI (26% female, median age 60 (IQR 53–67) years, smoking history 32 (23–45) pack-years) were recruited. The proportion with any COPD was 36%. Clinically-significant COPD was found in 30 participants (13.9%, 95% CI 9.5–19.2). Of these, 43% had a prior COPD diagnosis, 20% had an eosinophil count ≥300 cells/mm3, mean CAT score was 14.4 ± 9.3), 80% had high symptom burden (CAT score >10) and 23% were receiving ICS. The Swedish cohort included 302 participants with MI (24% female, median age 68 (IQR 61–76) years, 26 (15–38) pack years), and clinically-significant COPD was found in 52 (17.2%; 12.9–21.5). In these 52 participants, 17% had a prior COPD diagnosis, 20% had an eosinophil count ≥300 cells/mm3, mean CAT score was 12.9 ± 7.2, 63% had CAT score ≥10 and 15% had treatment with ICS.Conclusions: The prevalence of preliminary diagnosis of clinically-significant COPD in patients with a ≥10 pack-year smoking history hospitalised for MI is similar between two European cohorts and under-recognised. Further work is warranted to determine whether identification and treatment of COPD improves clinical outcomes following MI.
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| 2. |
- Kassab, Christine M., et al.
(författare)
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Formation and evolution of an extensive blue ice moraine in central Transantarctic Mountains, Antarctica
- 2020
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Ingår i: Journal of Glaciology. - : CAMBRIDGE UNIV PRESS. - 0022-1430 .- 1727-5652. ; 66:255, s. 49-60
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Tidskriftsartikel (refereegranskat)abstract
- Mount Achernar moraine is a terrestrial sediment archive that preserves a record of ice-sheet dynamics and climate over multiple glacial cycles. Similar records exist in other blue ice moraines elsewhere on the continent, but an understanding of how these moraines form is limited. We propose a model to explain the formation of extensive, coherent blue ice moraine sequences based on the integration of ground-penetrating radar (GPR) data with ice velocity and surface exposure ages. GPR transects (100 and 25 MHz) both perpendicular and parallel to moraine ridges at Mount Achernar reveal an internal structure defined by alternating relatively clean ice and steeply dipping debris bands extending to depth, and where visible, to the underlying bedrock surface. Sediment is carried to the surface from depth along these debris bands, and sublimates out of the ice, accumulating over time (>300 ka). The internal pattern of dipping reflectors, combined with increasing surface exposure ages, suggest sequential exposure of the sediment where ice and debris accretes laterally to form the moraine. Subsurface structure varies across the moraine and can be linked to changes in basal entrainment conditions. We speculate that higher concentrations of debris may have been entrained in the ice during colder glacial periods or entrained more proximal to the moraine sequence.
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