scholarly journals Association of total pre-existing comorbidities with stroke risk: a large-scale community-based cohort study from China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ya Zhang ◽  
Cuicui Wang ◽  
Dong Liu ◽  
Zhengyuan Zhou ◽  
Shujun Gu ◽  
...  
Keyword(s):  
Heart Disease ◽  
Large Scale ◽  
Stroke Risk ◽  
Baseline Survey ◽  
Chronic Obstructive ◽  
Risk Indicator ◽  
Community Based ◽  
Obstructive Pulmonary Disease ◽  
Previous Stroke ◽  
Increased Risk

Abstract Background Comorbidities, any other coexisting diseases in patients with a particular index disease, are known to increase the mortality of a stroke. However, the association of pre-existing comorbidities with stroke risk has not been fully studied. Methods This study included 16,246 adults from a prospective community-based cohort with a baseline survey conducted in 2013 in China. Participants were followed up with hospitalization records and the Cause of Death Registry. The association of eight pre-existing comorbidities (coronary heart disease, hyperlipidemia, hypertension, diabetes, previous stroke, chronic obstructive pulmonary disease, nephropathy, and cancer) with stroke risk was analyzed using the Cox proportional hazard model in 2020. Results At a median follow-up of 5.5 years, a total of 449 participants (206 men and 243 women) developed a stroke. Four pre-existing comorbidities (hypertension, congenital heart disease, previous stroke, and diabetes) were independently and positively associated with the risk for all types of stroke. The adjusted hazard ratios for participants with only 1 and ≥ 2 pre-existing comorbidities compared with those without pre-existing conditions were 1.96 (95% CI: 1.44, 2.67; P < 0.001) and 2.87 (95% CI; 2.09, 3.94; P < 0.001) for total stroke, respectively. Moreover, male and female participants with a combination of increased age and a higher number of pre-existing comorbidities experienced the greatest risk of stroke. Conclusions The number of pre-existing comorbidities was independently associated with an increased risk of stroke. There was a synergic effect between increased age and a higher number of pre-existing comorbidities on stroke occurrence. Our novel findings emphasize the importance and potential application of pre-existing comorbidities as a risk indicator in stroke prevention.

scholarly journals Clinical outcomes of theophylline use as add-on therapy in patients with chronic obstructive pulmonary disease: A propensity score matching analysis

2018 ◽  
Vol 16 ◽  
pp. 147997311881569 ◽  
Author(s):  
Preyanate Wilairat ◽  
Kirati Kengkla ◽  
Chaiyawat Thayawiwat ◽  
Phongsathorn Phlaisaithong ◽  
Supakorn Somboonmee ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Propensity Score ◽  
Hospital Admission ◽  
Pulmonary Disease ◽  
Clinical Outcomes ◽  
Large Scale ◽  
Airflow Obstruction ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk

To examine clinical outcomes of theophylline use in patients with chronic obstructive pulmonary disease (COPD) receiving inhaled corticosteroids (ICS) and long-acting beta-2 agonists (LABA). Electronic data from five hospitals located in Northern Thailand between January 2011 and December 2015 were retrospectively collected. Propensity score (PS) matching (2:1 ratio) technique was used to minimize confounding factors. The primary outcome was overall exacerbations. Secondary outcomes were exacerbation not leading to hospital admission, hospitalization for exacerbation, hospitalization for pneumonia, and all-cause hospitalizations. Cox’s proportional hazards models were used to estimate adjusted hazard ratio (aHR) and 95% confidence interval (CI). After PS matching, of 711 patients with COPD (mean age: 70.1 years; 74.4% male; 60.8% severe airflow obstruction), 474 theophylline users and 237 non-theophylline users were included. Mean follow-up time was 2.26 years. Theophylline significantly increased the risk of overall exacerbation (aHR: 1.48, 95% CI: 1.11–1.96; p = 0.008) and exacerbation not leading to hospital admission (aHR: 1.47, 95% CI: 1.06–2.03; p = 0.020). Theophylline use did not significantly increase the risk of hospitalization for exacerbation (aHR: 1.11, 95% CI: 0.79–1.58; p = 0.548), hospitalization for pneumonia (aHR: 1.28, 95% CI: 0.89–1.84; p = 0.185), and all-cause hospitalizations (aHR: 1.03, 95% CI: 0.80–1.33; p = 0.795). Theophylline use as add-on therapy to ICS and LABA might be associated with an increased risk for overall exacerbation in patients with COPD. A large-scale prospective study of theophylline use investigating both safety and efficacy is warranted.

scholarly journals Phenome-wide association analysis of LDL-cholesterol lowering genetic variants in PCSK9

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Amand F. Schmidt ◽  
◽  
Michael V. Holmes ◽  
David Preiss ◽  
Daniel I. Swerdlow ◽  
...  
Keyword(s):  
Genetic Variation ◽  
Large Scale ◽  
Plasma Lipid ◽  
Blood Lipid ◽  
Chronic Obstructive ◽  
Genetic Associations ◽  
Obstructive Pulmonary Disease ◽  
Pcsk9 Inhibitor ◽  
Increased Risk ◽  
Individual Participant

Abstract Background We characterised the phenotypic consequence of genetic variation at the PCSK9 locus and compared findings with recent trials of pharmacological inhibitors of PCSK9. Methods Published and individual participant level data (300,000+ participants) were combined to construct a weighted PCSK9 gene-centric score (GS). Seventeen randomized placebo controlled PCSK9 inhibitor trials were included, providing data on 79,578 participants. Results were scaled to a one mmol/L lower LDL-C concentration. Results The PCSK9 GS (comprising 4 SNPs) associations with plasma lipid and apolipoprotein levels were consistent in direction with treatment effects. The GS odds ratio (OR) for myocardial infarction (MI) was 0.53 (95% CI 0.42; 0.68), compared to a PCSK9 inhibitor effect of 0.90 (95% CI 0.86; 0.93). For ischemic stroke ORs were 0.84 (95% CI 0.57; 1.22) for the GS, compared to 0.85 (95% CI 0.78; 0.93) in the drug trials. ORs with type 2 diabetes mellitus (T2DM) were 1.29 (95% CI 1.11; 1.50) for the GS, as compared to 1.00 (95% CI 0.96; 1.04) for incident T2DM in PCSK9 inhibitor trials. No genetic associations were observed for cancer, heart failure, atrial fibrillation, chronic obstructive pulmonary disease, or Alzheimer’s disease – outcomes for which large-scale trial data were unavailable. Conclusions Genetic variation at the PCSK9 locus recapitulates the effects of therapeutic inhibition of PCSK9 on major blood lipid fractions and MI. While indicating an increased risk of T2DM, no other possible safety concerns were shown; although precision was moderate.

scholarly journals Association between fasting blood glucose levels and stroke events: a large-scale community-based cohort study from China

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050234
Author(s):  
Ya Zhang ◽  
Shujun Gu ◽  
Cuicui Wang ◽  
Dong Liu ◽  
Qiuyi Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Glucose ◽  
Stroke Risk ◽  
Eastern China ◽  
Fasting Blood Glucose ◽  
Baseline Survey ◽  
Community Based ◽  
Increased Risk ◽  
Incident Cases ◽  
Fourth Quartile

ObjectivesDiabetes mellitus has been associated with stroke. However, the association between fasting blood glucose (FBG) and stroke risk in a general population remains not clear. The purpose of our study was to examine the FBG levels on subsequent stroke risk in a community-based cohort in China.DesignProspective cohort study, employing Cox proportional hazard model to analyse the association of FBG levels with stroke risk.SettingA community-based cohort study included adults participating in a baseline survey conducted in 2013 in Changshu, eastern China.Participants16 113 participants were recruited with a multistage sampling method, excluding participants with severe disability, severe cancer, severe psychiatric disturbance or previous stroke before enrolment.Primary outcome measuresStroke events.ResultsDuring a median follow-up of 5.5 years, 417 incident cases of stroke were identified. The adjusted HR for total and ischaemic stroke for participants in the fourth quartile of FBG compared with the first quartile was 1.44 (95% CI 1.07 to 1.94) and 1.57 (95% CI 1.11 to 2.21), respectively. FBG levels of ≥7.0 mmol/L were associated with an increased risk of stroke based on two clinical classifications (American Diabetes Association: 1.68 (1.24 to 2.27); WHO: 1.62 (1.21, 2.13)). In stratified analyses, risk associations existed in women (HR: 1.92, 95% CI 1.22 to 3.01) and postmenopausal women (HR: 1.68, 95% CI 1.06 to 2.68) for the fourth quartile versus the first. More importantly, the meta-analysis observed a positive association between FBG levels and stroke risk (pooled HR: 1.70, 95% CI 1.27 to 2.29; n=7)).ConclusionsHigher FBG level was independently associated with an increased risk of stroke in Chinese adults, especially significant in women.

scholarly journals COVID-19 Prevalence and Mortality Among Schizophrenia Patients: A Large-Scale Retrospective Cohort Study

2021 ◽  
Author(s):  
Dana Tzur Bitan ◽  
Israel Krieger ◽  
Khalaf Kridin ◽  
Doron Komantscher ◽  
Yochai Scheinman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Large Scale ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Total N ◽  
Logistic Regression Models ◽  
Disease Characteristics ◽  
Increased Risk ◽  
Potential Risk Factors

Abstract Objective Individuals with schizophrenia may be at an increased risk for COVID-19 morbidity due to the disease characteristics. In this study, we aimed to explore the odds of significant COVID-19 morbidity and mortality among schizophrenia patients while controlling for potential sociodemographic and medical confounders. Methods Schizophrenia patients and age-and-sex matched controls (total n = 51 078) were assessed for frequency of COVID-19 positivity, hospitalizations, and mortality. The odds for COVID-19-associated hospitalization and mortality were calculated using logistic regression models, while controlling for age, sex, marital status, sector, socioeconomic status, diabetes, ischemic heart disease, hypertension, hyperlipidemia, obesity, smoking, and chronic obstructive pulmonary disease. Results Individuals with schizophrenia were less likely to test positive for COVID-19; however, they were twice as likely to be hospitalized for COVID-19 (OR 2.15 95% CI 1.63–2.82, P &lt; .0001), even after controlling for sociodemographic and clinical risk factors (OR 1.88 95% CI 1.39–2.55, P &lt; .0001). Furthermore, they were 3 times more likely to experience COVID-19 mortality (OR 3.27 95% CI 1.39–7.68, P &lt; .0001), compared to controls. Conclusions We found evidence of associations between schizophrenia and increased COVID-19 morbidity and mortality compared to controls regardless of sociodemographic and medical factors. As these patients present with a combination of potential risk factors for mortality, efforts should be made to minimize the effects of the pandemic on this vulnerable population.

scholarly journals Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study

2021 ◽  
Vol 12 ◽  
pp. 204062232110159
Author(s):  
Jung Eun Yoo ◽  
Dahye Kim ◽  
Hayoung Choi ◽  
Young Ae Kang ◽  
Kyungdo Han ◽  
...  
Keyword(s):  
Physical Activity ◽  
Screening Program ◽  
Chronic Obstructive ◽  
Older Population ◽  
Timed Up And Go ◽  
Obstructive Pulmonary Disease ◽  
Mild Anemia ◽  
Increased Risk ◽  
Male Sex

Background: The aim of this study was to investigate whether physical activity, sarcopenia, and anemia are associated an with increased risk of tuberculosis (TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National Screening Program for Transitional Ages for Koreans from 2009 to 2014. At baseline, we assessed common health problems in the older population, including anemia and sarcopenia. The subjects’ performance in the timed up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was determined using claims data from the National Health Insurance Service database. Results: The median follow-up duration was 6.4 years. There was a significant association between the severity of anemia and TB incidence, with an adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI), 1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to severe anemia. Compared with those who had normal TUG times, participants with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR 1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95% CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity reduced the risk of TB. Male sex, lower income, alcohol consumption, smoking, diabetes, and asthma/chronic obstructive pulmonary disease increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia, sarcopenia, and physical inactivity. Physicians should be aware of those modifiable predictors for TB among the older population.

scholarly journals LINC01414/LINC00824 genetic polymorphisms in association with the susceptibility of chronic obstructive pulmonary disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoman Zhou ◽  
Yunjun Zhang ◽  
Yutian Zhang ◽  
Quanni Li ◽  
Mei Lin ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Genetic Polymorphisms ◽  
Chronic Obstructive ◽  
Nucleotide Polymorphisms ◽  
Obstructive Pulmonary Disease ◽  
Logistic Analysis ◽  
Copd Patients ◽  
Increased Risk ◽  
And Gender

Abstract Objective Chronic obstructive pulmonary disease (COPD) is a complicated multi-factor, multi-gene disease. Here, we aimed to assess the association of genetic polymorphisms in LINC01414/ LINC00824 and interactions with COPD susceptibility. Methods Three single nucleotide polymorphisms (SNPs) in LINC01414/LINC00824 was genotyped by Agena MassARRAY platform among 315 COPD patients and 314 controls. Logistic analysis adjusted by age and gender were applied to estimate the genetic contribution of selected SNPs to COPD susceptibility. Results LINC01414 rs699467 (OR = 0.73, 95% CI 0.56–0.94, p = 0.015) and LINC00824 rs7815944 (OR = 0.56, 95% CI 0.31–0.99, p = 0.046) might be protective factors for COPD occurrence, while LINC01414 rs298207 (OR = 2.88, 95% CI 1.31–6.31, p = 0.008) risk-allele was related to the increased risk of COPD in the whole population. Rs7815944 was associated with the reduced risk of COPD in the subjects aged > 70 years (OR = 0.29, p = 0.005). Rs6994670 (OR = 0.57, p = 0.007) contribute to a reduced COPD risk, while rs298207 (OR = 7.94, p = 0.009) was related to a higher susceptibility to COPD at age ≤ 70 years. Rs298207 (OR = 2.54, p = 0.043) and rs7815944 (OR = 0.43, p = 0.028) variants was associated COPD risk among males. Rs7815944 (OR = 0.16, p = 0.031) was related to the reduced susceptibility of COPD in former smokers. Moreover, the association between rs298207 genotype and COPD patients with dyspnea was found (OR = 0.50, p = 0.016), and rs7815944 was related to COPD patients with wheezing (OR = 0.22, p = 0.008). Conclusion Our finding provided further insights into LINC01414/LINC00824 polymorphisms at risk of COPD occurrence and accumulated evidence for the genetic susceptibility of COPD.

Heart failure in Acute Coronary Syndrome: predictors and prognosis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Santos ◽  
H Santos ◽  
I Almeida ◽  
H Miranda ◽  
C Sa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Artery Bypass ◽  
Study Data ◽  
Multivessel Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome ◽  
Funding Sources ◽  
Previous Stroke ◽  
St Elevation

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf on behalf of the Investigators of " Portuguese Registry of ACS " Introduction Heart failure (HF) is a frequent complication of acute coronary syndromes (ACS). Therefore, it is important to access its impact on prognosis and identify patients (pts) with higher risk of HF. Objective To evaluate predictors and prognosis of HF in the setting of ACS. Methods Based on a multicenter retrospective study, data collected from admissions between 1/10/2010 and 4/09/2019. Pts without data on cardiovascular history or uncompleted clinical data were excluded. Pts were divided in 2 groups (G): GA – pts without HF; GB - pts with HF during hospitalization. Results HF occurred in 4003 (15.6%) out of 25718 pts with ACS. GB was older (74 ± 12 vs 65 ± 13, p &lt; 0.001), had more females (36.3% vs 26.2%, p &lt; 0.001), had higher rates of arterial hypertension (78.4% vs 69.3%, p &lt; 0.001), dyslipidaemia (64.4% vs 61.1%. p &lt; 0.001), previous ACS (25.6% vs 19.7%, p &lt; 0.001,), previous HF (16.4% vs 4.1%, p &lt; 0.001), previous stroke (11.9% vs 6.4%, p &lt; 0.001), chronic kidney disease (CKD) (17.1% vs 5.5%, p &lt; 0.001), chronic obstructive pulmonary disease (COPD) (7.8% vs 3.8%, p &lt; 0.001) and longer times from first symptoms to admission (268min vs 238min, p &lt; 0.001). GA had higher rate of smokers (28.4% vs 16.2%, p &lt; 0.001) and higher rate of non-ST-elevation myocardial infarction (MI) (46.5% vs 43.0%, p &lt; 0.001). GB had higher rates of ST-elevation MI (STEMI) (49.2% vs 41.1%, p &lt; 0.001), namely anterior STEMI (58.1% vs 44.9%, p &lt; 0.001). GB had lower blood pressure (130 ± 32 vs 140 ± 28, p &lt; 0.001), higher heart rate (86 ± 23 vs 76 ± 18, p &lt; 0.001), Killip-Kimball class (KKC) ≥2 (63.2% vs 6.7%, p &lt; 0.001), atrial fibrillation (AF) (15.4% vs 5.7%, p &lt; 0.001), left bundle branch block (7.5% vs 3.1%, p &lt; 0.001) and were previously treated with diuretics (39.1% vs 22.1%, p &lt; 0.001), amiodarone (2.2% vs 1.4%, p &lt; 0.001) and digoxin (2.8% vs 0.7%, p &lt; 0.001). GB had higher rates of multivessel disease (66.0% vs 49.5%, p &lt; 0.001) and planned coronary artery bypass grafting (7.3% vs 6.0%, p &lt; 0.001), reduced left ventricle function (72.3% vs 33.4%, p &lt; 0.001) and needed more frequently mechanical ventilation (8.2% vs 0.9%, p &lt; 0.001), non-invasive ventilation (8.7% vs 0.5%, p &lt; 0.001) and provisory pacemaker (4.5% vs 1.0%, p &lt; 0.001). Logistic regression confirmed females (p &lt; 0.001, OR 1.42, CI 1.29-1.58), diabetes (p &lt; 0.001, OR 1.43, CI 1.30-1.58), previous ACS (p &lt; 0.001, OR 1.27, CI 1.10-1.47), previous stroke (p &lt; 0.001, OR 1.35, CI 1.16-1.57), CKD (p &lt; 0.001, OR 1.76, CI 1.50-2.05), COPD (p &lt; 0.001, OR 2.15, CI 1.82-2.54), previous usage of amiodarone (p = 0.041, OR 1.35, CI 1.01-1.81) and digoxin (p &lt; 0.001, OR 2.30, CI 1.70-3.16), and multivessel disease (p &lt; 0.001, OR 1.64, CI 1.67-2.32) were predictors of HF in the setting of ACS. Event-free survival was higher in GA than GB (79.5% vs 58.1%, OR 2.3, p &lt; 0.001, CI 2.09-2.56). Conclusion As expected, HF in the setting of ACS is associated with poorer prognosis. Several features may help predict the HF occurrence during hospitalizations, allowing an earlier treatment.

scholarly journals Influenza in Malaysian adult patients hospitalized with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease or asthma: a multicenter, active surveillance study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong Kek Pang ◽  
Ahmad Izuanuddin Ismail ◽  
Yoke Fun Chan ◽  
Adelina Cheong ◽  
Yoong Min Chong ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Active Surveillance ◽  
Community Acquired Pneumonia ◽  
Surveillance Study ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
High Dependency ◽  
Increased Risk

Abstract Background Available data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings. Methods We conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute exacerbation of asthma (AEBA), who had influenza-like illness ≤10 days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13 months (July 2018–August 2019) and described the distribution of causative influenza strains. We evaluated predictors of laboratory-confirmed influenza and severe clinical outcomes using multivariate analysis. Results Of 1106 included patients, 114 (10.3%) were influenza-positive; most were influenza A (85.1%), with A/H1N1pdm09 being the predominant circulating strain during the study following a shift from A/H3N2 from January–February 2019 onwards. In multivariate analyses, an absence of comorbidities (none versus any comorbidity [OR (95%CI), 0.565 (0.329–0.970)], p = 0.038) and of dyspnea (0.544 (0.341–0.868)], p = 0.011) were associated with increased risk of influenza positivity. Overall, 184/1106 (16.6%) patients were admitted to intensive care or high-dependency units (ICU/HDU) (13.2% were influenza positive) and 26/1106 (2.4%) died (2.6% were influenza positive). Males were more likely to have a severe outcome (ICU/HDU admission or death). Conclusions Influenza was a significant contributor to hospitalizations associated with CAP, AECOPD and AEBA. However, it was not associated with ICU/HDU admission in this population. Study registration, NMRR ID: NMRR-17-889-35,174.

scholarly journals Understanding racial differences of COPD patients with an ecological model: two large cohort studies in the US and Korea

2021 ◽  
Vol 12 ◽  
pp. 204062232098245
Author(s):  
Hye Yun Park ◽  
Hyun Lee ◽  
Danbee Kang ◽  
Hye Sook Choi ◽  
Yeong Ha Ryu ◽  
...  
Keyword(s):  
Racial Differences ◽  
Large Scale ◽  
Ecological Model ◽  
Prevalence Ratio ◽  
Poor Quality ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Us

Background: There are limited data about the racial difference in the characteristics of chronic obstructive pulmonary disease (COPD) patients who are treated at clinics. We aimed to compare sociodemographic and clinical characteristics between US and Korean COPD patients using large-scale nationwide COPD cohorts. Methods: We used the baseline demographic and clinical data of COPD patients aged 45 years or older with at least a 10 pack-per year smoking history from the Korean COPD Subtype Study (KOCOSS, n = 1686) cohort (2012–2018) and phase I (2008–2011) of the US Genetic Epidemiology of COPD (COPDGene) study ( n = 4477, 3461 were non-Hispanic whites [NHW], and 1016 were African Americans [AA]). Results: Compared to NHW, AA had a significantly lower adjusted prevalence ratio (aPR) of cough >3 months (aPR: 0.67; 95% CI [confidence interval]: 0.60–0.75) and phlegm >3 months (aPR: 0.78, 95% CI: 0.70–0.86), but higher aPR of dyspnea (modified Medical Round Council scale ⩾2) (aPR: 1.22; 95% CI: 1.15–1.29), short six-minute walk distance (<350 m) (aPR: 1.98; 95% CI: 1.81–2.14), and poor quality of life (aPR: 1.10; 95% CI: 1.05–1.15). Compared to NHW, Koreans had a significantly lower aPR of cough >3 months (aPR: 0.53; 95% CI: 0.47–0.59), phlegm >3 months (aPR: 0.75; 95% CI: 0.67–0.82), dyspnea (aPR: 0.72; 95% CI: 0.66–0.79), and moderate-to-severe acute exacerbation in the previous year (aPR: 0.73; 95% CI: 0.65–0.82). NHW had the highest burden related to chronic bronchitis symptoms and cardiovascular diseases related to comorbidities. Conclusion: There are substantial differences in sociodemographic characteristics, clinical presentation, and comorbidities between COPD patients from the KOCOSS and COPDGene, which might be caused by interactions between various intrapersonal, interpersonal, and environmental factors of the ecological model. Thus, a broader and more comprehensive approach would be necessary to understand the racial differences of COPD patients.

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