CONGRESO ARC EN EPOC

7/24/2019 CONGRESO ARC EN EPOC

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Mesa 1. EPOC epidemiologa y diagnstico

Dr. Borj

Coso PHospital Univers

Ma


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[ATS] Alpha 1 - Antitrypsin

Deficiency And

Abdominal Aortic

Aneurysms: Does This

Association Really Exist?

Pini L, Bonardelli S,

Ferrarotti I, et al.


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Hipothesis

A1AT is one of the major protease

inhibitors present in human plasma An underlying structural defect of

the extracellular matrix (ECM) is

always present and the loss of

elastic fibers is an early step in AAAformation.

Therefore, AATD seems to be a reasonable risk factor for AAA because it is re

protease/anti-protease imbalance and enhanced degradation of ECM of the v


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Objectives

To investigate the distribution of AATD geno138 consecutive patients hospitalized for no

traumatic rupture of AAA.

The second purpose was to observe the disof the main non genetic risk factors for AAA

between patients: with and without AATD.

id i l di i


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Results

AAA patients with and without AATD we found no differences in terms of age, gend

hypertension, diabetes and smoke habits, but hyperlipidemia was significantly less

group of patients with AATD (46.4 vs 12.5 % respectively, P


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Discussion

CONCLUSION: In AAA patients the frequency of S allele was

higher than in the general Italian population. Our preliminaryresults support the hypothesis that AATD might represent a

risk factor for AAA.

Previous reports:

J Surg Research 1990

Mesa 1 EPOC epidemiologa y diagnstico


7/18


[ATS] Risk Factors For

COPD Exacerbations In

Inhaled Medication Users:

COPDGene StudyBiannual Longitudinal

Follow-UpBusch R, Bowler RP, Han MK;

COPDgene Investigators



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Background and objectives

Despite inhaled medications that decrease

exacerbation risk, some COPD patients continueto have frequent exacerbations.

Aim: to determine prospective risk factors for

acute exacerbations of COPD (AECOPD)

among subjects in the COPDGene study taking

inhaled respiratory medications.



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Methods

Retrospective data from the COPDGene study and pros

data from the telephone- and web-based biannual LongFollow-Up program (LFU).

Medication use groups (TIO/LABA/ICS, TIO, LABA/ICS,were defined by subject self-report.

Exacerbators and nonexacerbators were identified by thfrequency of AECOPD (exacerbators had one or more Aper year, non-exacerbators had zero AECOPD per year)

Associations between AECOPD occurrence and demogspirometry, chest CT data, and comorbidities were teste


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Results

Subjects taking either LABA/ICS or TIO had similar

characteristics such as FEV1, 6-minute walk distancpercent emphysema by CT scan, and pack-years ofsmoking.

Comparing subjects taking tiotropium vs. long-actagonist/inhaled corticosteroid, tiotropium subject

a trend towards statistically significantly lower rateexacerbations (OR = 0.69 [95 % CI 0.45, 1.06], p= 0especially in subjects without a doctor's diagnosis asthma (OR =0.56 [95 % CI 0.31, 1.00], p=0.05).



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Discussion

Conclusion: Characteristic risk factor profiles for exacerba

help identify subjects at risk for AECOPD



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p g y g

[ERS] Distribution of

COPD phenotypes

according to the Spanish

COPD guidelines

in clinical practiceMiravitlles M, Calle M, Rodrguez

JL, Murio C, On Behalf of the

FENEPOC Study Group



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p g y g

Background and aims

Aims. To determine the frequency of COPD phenotypes in Spanish clinical prac

and the availability of diagnostic tools.



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p g y g

Methods

Epidemiological, cross-sectional and multicentre study.

Patients >40 years with COPD, (FEV/FVC10 pack-years) were included.

The availability of diagnostic tools to classify COPD pheno

assessed by an ad-hoc questionnaire.



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Results 647 patients [294 Primary Care and 353 Pulmonology]

Investigators reported that>80 % of DT were available, with exceptiontomography (26.9 %) and carbon monoxide transfer test (13.5 %) in Psputum eosinophilia (40.4 % PC and 49.4 % P).

ACOS (42, 6.5 %) ECB (188, 29.1 %) EE (110, 17.0 %)

Age(years), mean(SD) 64.2(9.0) 69.5(8.6) 70.0(9.1)

Sex(male), n( %) 21(50.0) 157(83.5) 90(81.8)

Pack-years, mean(SD) 39.4(17.7) 42.8(21.2) 48.5(25.5)

FEV post-BD( %), mean(SD) 61.5(28.1) 54.8(21.0) 47.9(16.4)

m-MRC scale, mean(SD) 1.8(0.8) 2.1(0.8) 2.2(1.0)

N exacerbations, mean(SD) 3.2(2.5) 3.6(1.7) 3.7(1.9)



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Discussion Conclusion: In clinical practice, most COPD patients were

predominantly NE. In general, investigators have the requfor diagnosing COPD phenotypes.



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Muchas gracias

por su atencin

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