mesa 1.2 borja garcía cosío

Mesa 1. EPOC epidemiología y diagnóstico

Dr. Borja García-

Cosío PiquerasHospital Universitario Son Espases.

Mallorca


[ATS] Alpha 1 - Antitrypsin

Deficiency And

Abdominal Aortic

Aneurysms: Does This

Association Really Exist?

Pini L, Bonardelli S,

Ferrarotti I, et al.


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 AAA

formation.

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

protease/anti-protease imbalance and enhanced degradation of ECM of the vessel wall.


Objectives

• To investigate the distribution of AATD genotypes in

138 consecutive patients hospitalized for non-

traumatic rupture of AAA.

• The second purpose was to observe the distribution

of the main non genetic risk factors for AAA

between patients: with and without AATD.


Results

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

hypertension, diabetes and smoke habits, but hyperlipidemia was significantly less frequent in the

group of patients with AATD (46.4 vs 12.5 % respectively, P<0.05).

Out of 138 patients, 20 were found with A1ATD: 16 MS, 1 SS, 3MZ and 2 with new rare

normal variants of AAT

% o

f pat

ient

s

P<0.01

NS


Discussion

• CONCLUSION: In AAA patients the frequency of S allele was

higher than in the general Italian population. Our preliminary

results support the hypothesis that AATD might represent a

risk factor for AAA.

• Previous reports:

J Surg Research 1990


[ATS] Risk Factors For

COPD Exacerbations In

Inhaled Medication Users:

COPDGene Study

Biannual Longitudinal

Follow-UpBusch R, Bowler RP, Han MK;

COPDgene Investigators


Background and objectives

• Despite inhaled medications that decrease

exacerbation risk, some COPD patients continue

to 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.


Methods

• Retrospective data from the COPDGene study and prospective data from the telephone- and web-based biannual Longitudinal Follow-Up program (LFU).

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

• Exacerbators and nonexacerbators were identified by the frequency of AECOPD (exacerbators had one or more AECOPD per year, non-exacerbators had zero AECOPD per year).

• Associations between AECOPD occurrence and demographics, spirometry, chest CT data, and comorbidities were tested.


Results

GERD

Female gender

Higher total SGRQ scores


Results

• Subjects taking either LABA/ICS or TIO had similar characteristics such as FEV1, 6-minute walk distance, percent emphysema by CT scan, and pack-years of smoking.

• Comparing subjects taking tiotropium vs. long-acting beta-agonist/inhaled corticosteroid, tiotropium subjects showed a trend towards statistically significantly lower rates of exacerbations (OR = 0.69 [95 % CI 0.45, 1.06], p= 0.09), especially in subjects without a doctor's diagnosis of asthma (OR =0.56 [95 % CI 0.31, 1.00], p=0.05).


Discussion

• Conclusion: Characteristic risk factor profiles for exacerbators may

help identify subjects at risk for AECOPD


[ERS] Distribution of

COPD phenotypes

according to the Spanish

COPD guidelines

in clinical practiceMiravitlles M, Calle M, Rodríguez

JL, Murio C, On Behalf of the

FENEPOC Study Group


Background and aims

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

and the availability of diagnostic tools.


Methods

• Epidemiological, cross-sectional and multicentre study.

• Patients >40 years with COPD, (FEV₁/FVC<0.7 post-bronchodilator

[post-BC], and >10 pack-years) were included.

• The availability of diagnostic tools to classify COPD phenotypes was

assessed by an ad-hoc questionnaire.


Results• 647 patients [294 Primary Care and 353 Pulmonology]

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

ACOS (42, 6.5 %) ECB (188, 29.1 %) EE (110, 17.0 %) NE (307, 47.5 %)

Age(years), mean(SD) 64.2(9.0) 69.5(8.6) 70.0(9.1) 67.2(9.3)

Sex(male), n( %) 21(50.0) 157(83.5) 90(81.8) 255(83.1)

Pack-years, mean(SD) 39.4(17.7) 42.8(21.2) 48.5(25.5) 42.9(23.6)

FEV₁ post-BD( %), mean(SD) 61.5(28.1) 54.8(21.0) 47.9(16.4) 53.0(16.2)

m-MRC scale, mean(SD) 1.8(0.8) 2.1(0.8) 2.2(1.0) 1.5(0.8)

N exacerbations, mean(SD) 3.2(2.5) 3.6(1.7) 3.7(1.9) 0.7(0.7)


Discussion• Conclusion: In clinical practice, most COPD patients were

predominantly NE. In general, investigators have the required tools

for diagnosing COPD phenotypes.


Muchas gracias

por su atención

mesa 1.2 borja garcía cosío

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