SynthesisThorax2019
Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis.
Synthesis in Thorax, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
100 citing papers in PubMed, 5 syntheses or guidelines pooled it, 178 citations in OpenAlex.
- Breathing insights: Biomarkers as tools for chronic obstructive pulmonary disease assessment - A systematic review.Indian journal of pharmacology · 2026Pooled it
- Frailty in COPD: Clinical Impact, Diagnosis, Biomarkers, and Management Strategies.International journal of chronic obstructive pulmonary disease · 2025Pooled it
- Investigating the prognostic value of digital mobility outcomes in patients with chronic obstructive pulmonary disease: a systematic literature review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Epicardial adipose tissue in patients with chronic obstructive pulmonary disease: systematic review with meta‑analysis and trial sequential analysis.BMC pulmonary medicine · 2023Pooled it
- Effectiveness and safety of Suhuang Zhike capsule as adjuvant treatment for acute exacerbation of chronic obstructive pulmonary disease: a systematic review and Meta-analysis.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2023Pooled it
- Forest bathing improves inflammatory markers, SpO2, and subjective symptoms related to chronic obstructive pulmonary disease (COPD) in male subjects at risk of developing COPD.Journal of occupational health · 2025Trial
- Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure.ESC heart failure · 2024Trial
- Assessment of risk factors responsible for rapid deterioration of lung function over a period of one year in patients with chronic obstructive pulmonary disease.Scientific reports · 2021Trial
- Updates in COPD Management: From Inflammatory Pathways to Targeted Therapies.European journal of clinical investigation · 2026Review
- Airway Response to Dual Bronchodilation and Its Association with Inflammatory Markers in Treatment-Naïve Chronic Obstructive Pulmonary Disease: A Quantitative Computed Tomography Study.Life (Basel, Switzerland) · 2026Article
- Diagnostic and Monitoring Potential of Sputum-Derived miRNAs in Patients with Chronic Obstructive Pulmonary Disease.International journal of molecular sciences · 2026Review
- Multi-site microbiomes' response to chronic obstructive pulmonary disease.Microbiology spectrum · 2026Article
- Sex-Specific Plasma Metabolomic Signatures in COPD Reveal Creatine, Purine/Urate, and Bile-Acid Axes.Metabolites · 2026Article
- C-reactive protein predicts respiratory failure in chronic obstructive pulmonary disease: a cohort analysis from the UK Biobank.Journal of global health · 2026Article
- A Clinical Cut-Off Value for the Systemic Immune-Inflammation Index to Predict Frequent Exacerbations in Stable COPD.Medicina (Kaunas, Lithuania) · 2026Observational
- Association of C-Reactive Protein-Triglyceride Glucose Index With Chronic Obstructive Pulmonary Disease: Results From the NHANES and CHARLS Cohorts.Mediators of inflammation · 2026Article
- A machine learning model for predicting short-term in-hospital mortality in acute myocardial infarction with coexisting chronic obstructive pulmonary disease.Frontiers in cardiovascular medicine · 2026Article
- Elevated C-Reactive Protein-Albumin-Lymphocyte Index Is Associated With Reduced Mortality in Chronic Inflammatory Airway Diseases: A Population-Based Observational Study.Mediators of inflammation · 2026Observational
- Association between terbutaline sulfate plus ambroxol hydrochloride and clinical outcomes, pulmonary function, and inflammatory biomarkers in elderly patients with acute exacerbation of chronic obstructive pulmonary disease.Frontiers in pharmacology · 2026Article
- Associations between dietary inflammatory potential and COPD: the mediating role of inflammation.Frontiers in nutrition · 2026Article
40 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 8 institutions in 7 countries.
Funding
Abstract
backgroundConventional measures to evaluate COPD may fail to capture systemic problems, particularly musculoskeletal weakness and cardiovascular disease. Identifying these manifestations and assessing their association with clinical outcomes (ie, mortality, exacerbation and COPD hospital admission) is of increasing clinical importance.
objectiveTo assess associations between 6 min walk distance (6MWD), heart rate, fibrinogen, C reactive protein (CRP), white cell count (WCC), interleukins 6 and 8 (IL-6 and IL-8), tumour necrosis factor-alpha, quadriceps maximum voluntary contraction, sniff nasal inspiratory pressure, short physical performance battery, pulse wave velocity, carotid intima-media thickness and augmentation index and clinical outcomes in patients with stable COPD.
methodsWe systematically searched electronic databases (August 2018) and identified 61 studies, which were synthesised, including meta-analyses to estimate pooled HRs, following Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
resultsShorter 6MWD and elevated heart rate, fibrinogen, CRP and WCC were associated with higher risk of mortality. Pooled HRs were 0.80 (95% CI 0.73 to 0.89) per 50 m longer 6MWD, 1.10 (95% CI 1.02 to 1.18) per 10 bpm higher heart rate, 3.13 (95% CI 2.14 to 4.57) per twofold increase in fibrinogen, 1.17 (95% CI 1.06 to 1.28) per twofold increase in CRP and 2.07 (95% CI 1.29 to 3.31) per twofold increase in WCC. Shorter 6MWD and elevated fibrinogen and CRP were associated with exacerbation, and shorter 6MWD, higher heart rate, CRP and IL-6 were associated with hospitalisation. Few studies examined associations with musculoskeletal measures.
conclusionFindings suggest 6MWD, heart rate, CRP, fibrinogen and WCC are associated with clinical outcomes in patients with stable COPD. Use of musculoskeletal measures to assess outcomes in patients with COPD requires further investigation. TRIAL REGISTRATION NUMBER: CRD42016052075.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.