Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort Borja G. Cosio, MD, Joan B. Soriano, MD, Jose Luis López-Campos, MD, Myriam Calle-Rubio, MD, Juan José Soler-Cataluna, MD, Juan P. de-Torres, MD, Jose M. Marín, MD, Cristina Martínez-Gonzalez, MD, Pilar de Lucas, MD, Isabel Mir, MD, Germán Peces-Barba, MD, Nuria Feu-Collado, MD, Ingrid Solanes, MD, Inmaculada Alfageme, MD, Ciro Casanova, MD José Calvo Bonachera, MD, Celia Lacárcel Bautista, MD, Adolfo Domenech, MD, Rosirys Guzmán, MD, Rosa Irigaray, MD, Meritxell López Zamora, RN, Angel Ríos, RN, Rocío Córdova, RN, Carlos Cabrera López, Alejandro Sánchez Acosta, Juan Abreu González, Ramón Agüero Balbin, Eva Balcells, Elena Miguel Campos, Alicia Marin, Antonia Llunel Casanova, Amalia Moreno, Francisca Lourdes Márquez Pérez, Juan Antonio Riesco Miranda, Julia Tabara Rodríguez, Rafael Golpe Gómez, Javier de Miguel Díez, Francisco García Río, Salvador Díaz Lobato, Juan Bautista Galdiz Iturri, Margarita Marín Royo, Alfredo de Diego Damia Borja G. Cosio, MD, Joan B. Soriano, MD, Jose Luis López- Campos, MD, Myriam Calle-Rubio, MD, Juan José Soler-Cataluna, MD, Juan P. de-Torres, MD, Jose M. Marín, MD, Cristina Martínez- Gonzalez, MD, Pilar de Lucas, MD, Isabel Mir, MD, Germán Peces-Barba, MD, Nuria Feu-Collado, MD, Ingrid Solanes, MD, Inmaculada Alfageme, MD, Ciro Casanova, MD José Calvo Bonachera, MD, Celia Lacárcel Bautista, MD, Adolfo Domenech, MD, Rosirys Guzmán, MD, Rosa Irigaray, MD, Meritxell López Zamora, RN, Angel Ríos, RN, Rocío Córdova, RN, Carlos Cabrera López, Alejandro Sánchez Acosta, Juan Abreu González, Ramón Agüero Balbin, Eva Balcells, Elena Miguel Campos, Alicia Marin, Antonia Llunel Casanova, Amalia Moreno, Francisca Lourdes Márquez Pérez, Juan Antonio Riesco Miranda, Julia Tabara Rodríguez, Rafael Golpe Gómez, Javier de Miguel Díez, Francisco García Río, Salvador Díaz Lobato, Juan Bautista Galdiz Iturri, Margarita Marín Royo, Alfredo de Diego Damia  CHEST  Volume 149, Issue 1, Pages 45-52 (January 2016) DOI: 10.1378/chest.15-1055 Copyright © 2016 American College of Chest Physicians Terms and Conditions

Figure 1 Flowchart of patients according to guideline preestablished criteria. ACOS = asthma-COPD overlap syndrome. CHEST 2016 149, 45-52DOI: (10.1378/chest.15-1055) Copyright © 2016 American College of Chest Physicians Terms and Conditions

Figure 2 Venn diagram with factors associated with ACOS. Major and minor criteria are represented by proportional squares and nonproportional circles, respectively. Eos = eosinophils; PBD+ = positive bronchodilator test; PBD+++ = marked positive bronchodilator test (> 400 mL and 15%). See Figure 1 legend for expansion of other abbreviations. CHEST 2016 149, 45-52DOI: (10.1378/chest.15-1055) Copyright © 2016 American College of Chest Physicians Terms and Conditions

Figure 3 Stability of ACOS criteria after 1-y follow-up. See Figure 1 legend for expansion of abbreviations. CHEST 2016 149, 45-52DOI: (10.1378/chest.15-1055) Copyright © 2016 American College of Chest Physicians Terms and Conditions

Figure 4 One-year Kaplan-Meier cumulative survival, by ACOS. See Figure 1 legend for expansion of abbreviations. CHEST 2016 149, 45-52DOI: (10.1378/chest.15-1055) Copyright © 2016 American College of Chest Physicians Terms and Conditions