Background In chronic obstructive pulmonary disease (COPD), gender-specifc diferences in the prevalence of symptoms
and comorbidity are known.
Research question We studied whether the relationship between these characteristics depended on gender and carried diag nostic information regarding cardiac comorbidities.
Study design and methods The analysis was based on 2046 patients (GOLD grades 1–4, 795 women; 38.8%) from the
COSYCONET COPD cohort. Assessments comprised the determination of clinical history, comorbidities, lung function,
COPD Assessment Test (CAT) and modifed Medical Research Council dyspnea scale (mMRC). Using multivariate regres sion analyses, gender-specifc diferences in the relationship between symptoms, single CAT items, comorbidities and
functional alterations were determined. To reveal the relationship to cardiac disease (myocardial infarction, or heart failure,
or coronary artery disease) logistic regression analysis was performed separately in men and women.
Results Most functional parameters and comorbidities, as well as CAT items 1 (cough), 2 (phlegm) and 5 (activities), dif fered signifcantly (p<0.05) between men and women. Beyond this, the relationship between functional parameters and
comorbidities versus symptoms showed gender-specifc diferences, especially for single CAT items. In men, item 8 (energy),
mMRC, smoking status, BMI, age and spirometric lung function was related to cardiac disease, while in women primarily
age was predictive.
Interpretation Gender-specifc diferences in COPD not only comprised diferences in symptoms, comorbidities and func tional alterations, but also diferences in their mutual relationships. This was refected in diferent determinants linked to
cardiac disease, thereby indicating that simple diagnostic information might be used diferently in men and women.
Clinical trial registration The cohort study is registered on ClinicalTrials.gov with identifer NCT01245933 and on Ger manCTR.de with identifer DRKS00000284, date of registration November 23, 2010. Further information can be obtained
on the website http://www.asconet.net
