CHEST 2006 ABSTRACT BRIEFS
EMBARGO: Each Abstract is Embargoed Until the Day/Time Listed Below Title
Cardiovascular Disease
Medicare Part D May Hurt Heart Patients
(Monday, October 23, 2006, 4:30 PM EST)
The new Medicare Part D program may make it difficult for a significant number of indigent patients with systolic heart failure (SHF) to access evidence-based medical therapies, according to new research. Researchers followed 382 patients with SHF belonging to Louisiana’s Chabert Medical Center’s SHF disease management program. Patients had Medicare, and many utilized pharmaceutical-sponsored, medication-assistance programs (MAP) to access their life-saving therapies. MAP programs are potentially threatened as a result of the current change over to Medicare Part D. Patients had a mean age of 66.7 years and a median household income of $11,800 annually. In total, 95 percent of these patients with SHF used ace inhibitors, 96 percent used beta-blockers, and 65 percent obtained their medications via the MAP. Researchers conclude, that as a result of Medicare Part D payments and copayments, a considerable amount of patients with SHF may lose access to medications.
Long-Acting Beta Agonists Show No Link to Cardiac Events
(Tuesday, October 24, 2006, 2:30 PM Eastern)
Patients with chronic obstructive pulmonary disease (COPD) who take inhaled long-acting beta agonists (LABAs) are not at an increased risk for developing cardiovascular events (CVEs) due to their medication, shows a new study out of the University of Washington. Researchers compared 6,954 patients with COPD who used LABAs with a matched control group of 34,700 patients with COPD. Patients were followed until the earliest CVE, death, or five years after the start of the study. Results showed that patients using LABAs had a similar risk of experiencing a CVE compared to patients who never used LABAs. Furthermore, when researchers adjusted for cumulative use of LABAs, they found that as patients used LABAs for a longer time, their risk for CVEs remained similar to patients who were never exposed to LABAs.
Prolonged Ventilation in Muscular Dystrophy Increases Complications
(Wednesday, October 25, 2006, 12:30 PM EST)
New research from MetroHealth Medical Center in Ohio suggests that patients with Duchenne muscular dystrophy experience a higher incidence of noncardiopulmonary complications when prolonged survival involved assisted ventilation. Researchers conducted a retrospective chart review of 27 patients with DMD who were 20-years-old or older. A patient was considered to have had prolonged survival due to assisted ventilation, if that patient lived for more than five years after vital capacity fell below 1 L. In all, 19 patients suffered from one or more complications. Eighteen of these patients showed a survival mean of 6.5 years after their vital capacity fell below 1 L. Twelve of these patients were ventilated 24 hours a day. Researchers concluded that the there is a high frequency of major noncardiopulmonary complications in patients with Duchenne muscular dystrophy and ventilator-assisted prolonged survival, and those therapies for these complications impose additional risks.
Heart Murmurs More Common in Women
(Wednesday, October 25, 2006, 2:30 PM EST)
More than half of heart murmurs are innocent in origin and more prevalent in women, according to a new study out of the University of California, Irvine Medical Center. Researchers reviewed 7,684 echocardiograms for valvular abnormalities, which were referred with the primary diagnosis of a murmur. Of the 45 percent of echocardiograms referred for a murmur, 61 percent were of women. Though patients referred for murmur had more valvular abnormalities than those referred for other reasons, researchers found that the prevalence in this group was less than 50 percent. Furthermore, despite the high number of female murmur referrals, the percentage of abnormal valves in women was only 45 percent, compared with 53 percent in men.
Smaller Arteries May Reduce a Woman’s Likelihood for Successful Catheterization
(Wednesday, October 25, 2006, 2:30 PM EST)
A new study shows that smaller arterial size in women may account for the reduced likelihood of successful catheterization. Over a four-month period, researchers from New York recorded the age, body mass index (BMI), and gender of 40 patients requiring arterial catheters. Radial and femoral arteries were measured, and the association between their size and patient characteristics was assessed. Researchers concluded that, even after adjusted for age and BMI, the diameters for both radial and femoral arteries were significantly smaller in women than in men, possibly causing unsuccessful catheterizations in critically ill women.
Obstructive Sleep Apnea May Increase Complications After Heart Surgery
(Wednesday, October 25, 2006, 2:30 PM EST)
New research from the Cleveland Clinic Foundation suggests that cardiac surgery patients with obstructive sleep apnea (OSA) are at a higher risk for developing postoperative complications. Researchers compared the incidence of cardiac surgery complications in 37 OSA patients, identified through the cardiac surgery database, to another database sample absent of OSA. Patients, who underwent open-heart surgery within two years of an OSA diagnosis, were assumed to have had OSA at the time of surgery. Researchers found that the patients with OSA exhibited a higher incidence of encephalopathy, postoperative infection, and increased length of intensive care unit stays. It is suggested that this risk is underestimated due to lack of OSA incidence awareness, and that patients may need to be screened for OSA prior to cardiac surgery. |
