Public Release:  News briefs from the January issue of Chest

American College of Chest Physicians

SMALL, THIN CHILDREN MAY HAVE POORER LUNG FUNCTION

A new study shows that poor lung function during adolescence and through midlife may be influenced by several factors, including birth weight, height, and gender. Researchers from Newcastle University in the United Kingdom analyzed health data from 252 patients, all aged 14 years. Follow-up data also were obtained for 122 of the patients at age 49 to 51. Results showed that several factors were related to poorer lung function (as measured by FEV1) at age 14, including lower height, lower BMI, being breast-fed for less than 4 weeks, and childhood respiratory disease. Furthermore, several factors predicted a decline in lung function between the ages of 49 to 51 years, including more cigarettes smoked in the lifetime, having a higher FEV1 at age 14, and being female. Researchers note that women reach their maximum FEV1 at a younger age than men, which may explain why, after age 14, the lung function of women declines at a higher rate than the lung function of men. This article is published in the January issue of Chest, the peer-reviewed journal of the American College of Chest Physicians.

TIOTROPIUM ASSOCIATED WITH REDUCED MORTALITY

New research suggests that tiotropium, a long-acting anticholinergic used in patients with COPD, may be associated with a reduction in all-cause mortality, cardiovascular mortality, and cardiovascular events. Researchers from Caritas-St. Elizabeth Medical Center in Boston, MA, reviewed the outcomes of 30 completed clinical trials in the tiotropium project database. Within the trials, 10,846 patients were treated with tiotropium and 8,699 patients received a placebo. Results indicated that patients treated with tiotropium had lower incidence rates (IR) of all-cause mortality, cardiovascular mortality, and cardiovascular events (IR = 3.44, .91, and 2.15 per 100 patients, respectively), compared with placebo (IR = 4.10, 1.24, and 2.67, respectively). Within the tiotropium group, the overall risk for serious or fatal lower respiratory events also was reduced. The mechanism by which tiotropium may reduce cardiovascular mortality is unclear, but researchers speculate that there may be an association with the reduction in respiratory events. The article is published in the January issue of Chest, the peer-reviewed journal of the American College of Chest Physicians.

IPRATROPIUM BROMIDE MAY INCREASE RISK FOR CARDIOVASCULAR EVENTS

Patients taking ipratropium bromide, an anticholinergic used in the treatment of COPD, may be at an increased risk for cardiovascular events (CVE), including heart failure. Researchers from the University of Washington in Seattle, WA, and Hines VA Hospital in Hines, IL, conducted a cohort study on 82,717 US veterans with a new diagnosis of COPD between 1999 and 2002. Of the patients, 44 percent were exposed to anticholinergics (mainly ipratropium) at some time during the study. Patients were followed until they had their first hospitalization for a CVE, until they died, or until September 30, 2004. Within the cohort, 6,234 CVE were identified (44 percent heart failure, 28 percent acute coronary syndrome, and 28 percent dysrhythmias). Results showed that any exposure to anticholinergics within the past 6 months was associated with an increased risk of CVE. However, among patients who received anticholinergics more than 6 months prior, an elevated risk of CVE was not seen. Researchers note that their findings are consistent with previous concerns raised about the cardiovascular safety of ipratropium bromide. This study is published in the January issue of Chest, the peer-reviewed journal of the American College of Chest Physicians.

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