CHEST 2006 ABSTRACT BRIEFS
EMBARGO: Each Abstract is Embargoed Until the Day/Time Listed Below Title
Chronic Obstructive Pulmonary Disease (COPD)
COPD Progression More Rapid in Smokers
(Monday, October 23, 2006, 4:30 PM EST)
Patients with COPD, who continue to smoke, have the worst disease prognosis, according to a new study. Researchers from Illinois and Massachusetts collected the pyrometer data of 538 participants from the Framingham Heart Study. The participants were categorized according to Global Initiative for Obstructive Lung Disease (GOLD) stages at the beginning and end of 12 years, and smoking status, age, and gender were used to estimate disease progression. Participants were categorized as never smokers (16.1%), always smokers (42.5%), and intermittent smokers (37.6%). When stratified by smoking status, always smokers were shown more likely to have disease progression, having the lowest proportion of patients in the same GOLD stage at baseline and 12 years.
Long-Acting Beta Agonists Show No Link to Cardiac Events
(Tuesday, October 24, 2006, 2:30 PM Eastern)
Patients with 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 with 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.
Sildenafil May Improve Daily Activities in COPD
(Wednesday, October 25, 2006, 2:30 PM EST)
Patients who suffer from COPD may benefit from agents, such as sildenafil, that cause vasodilation, according to researchers from the Netherlands. The new study investigated the acute effects of sildenafil on patients with COPD both at rest and during exercise. The response was also tested on patients with COPD both with and without pulmonary hypertension (PH), which is a common complication of COPD. A total of 12 patients underwent heart catheterization, and both the mean pulmonary artery pressure and cardiac output were assessed. Three-minute cycling measurements were taken at baseline and then again 45 minutes after oral intake of sildenafil. Half of the patients were found to have PH. Researchers found that in all patients, sildenafil significantly lowered pulmonary arterial pressure during exercise. However, in the group without PH, pressure was reduced in both exercise and while at rest.
Vitamin C May Aid in COPD/Pneumonia Prognosis
(Wednesday, October 25, 2006, 2:30 PM EST)
During exacerbation, vitamin C is markedly decreased in inflammatory diseases, such as acute pneumonia and COPD, according to a new study. Serbian researchers compared the values of serum ascorbate concentration and laboratory inflammation indicators in 60 nonsmoking patients. The patients were split into three groups: 20 patients with acute pneumonia (group I), 20 patients with stable COPD (group II), and 20 patients with exacerbated COPD (group III). Researchers concluded that patients in groups I and III had significantly decreased levels of vitamin C and increased inflammation before therapy, compared with patients after therapy. It is suggested that the elevation of vitamin C in serum is a good prognostic parameter for disease evaluation.
Hyperglycemia in COPD May Lead to Longer Hospital Stays
(Wednesday, October 25, 2006, 2:30 PM EST)
Patients hospitalized with COPD and asthma exacerbations are likely to have poor glucose control and an associated increased length of stay (LOS) in the hospital, according to a study from Cooper University Hospital. Sixty-seven patients hospitalized for COPD or asthma exacerbations were evaluated for hyperglycemia and a correlation with LOS during corticosteroid treatment. Researchers assessed demographic data, corticosteroid dose and duration, glucose levels, and management. Researchers concluded poor glucose control and increased LOS were associated. Also, upon discharge, glucose monitoring with insulin coverage was not routinely prescribed to these patients.
COPD Underdiagnosed and Undertreated in Smokers
(Wednesday, October 25, 2006, 2:30 PM EST)
A new study suggests clinicians should be more aware of possible COPD in patients at risk for lung cancer. Researchers from the University of Alabama obtained the demographic, medical, and spirometric information of 449 subjects who smoked and were enrolled in the National Lung Screening Trial. Subjects were classified into Global Initiative for Obstructive Lung Disease (GOLD) stages, and those who had a diagnosis of COPD and were treated. In all, 53 percent had airway obstruction, and 36 percent had at least GOLD stage II. Of the 34 percent of subjects who carried a diagnosis of COPD, only 18 percent were treated. Researchers concluded that, based on traditional teachings, significant airflow obstructions occurred more frequently than expected.
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