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Newsbriefs from the July issue of the journal Chest


A new study suggests that the use of combination antithrombotic therapy may increase the risk of clinically relevant bleeding in patients with atrial fibrillation (AF). Researchers from the United Kingdom, the Netherlands, and France compared outcomes in 3,728 patients with AF receiving anticoagulation alone and 848 patients with AF receiving combination antithrombotic therapy (anticoagulant and antiplatelet therapy). Results showed that patients receiving combination therapy had a 2.3-fold increased risk of clinically relevant bleeding compared with anticoagulation therapy alone. Combination antithrombotic therapy also does not appear to reduce the risk of stroke. Results suggest that combination antithrombotic treatment is justified only in patients where the benefit of adding antiplatelet therapy to anticoagulant therapy outweighs bleeding risk. This article is published in the July issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians: Chest. 2011;140(1):146-155.


One in five patients diagnosed with pulmonary arterial hypertension (PAH) in the United States report symptoms for more than 2 years before diagnosis. PAH is a progressive and fatal disorder, and the disease is often advanced when recognized, especially in younger patients. Researchers from Intermountain Medical Center, the University of California, University of Pennsylvania, Baylor College of Medicine, Boston University, and Mayo Clinic studied 2,967 adult patients enrolled in the Registry to Evaluate Early Long-term PAH Disease Management (REVEAL), for an 18-month period. In 21.1% of patients, symptoms were experienced for more than two years before PAH was recognized. History of obstructive airways disease and sleep apnea were independently associated with delayed PAH recognition. Despite progress in understanding the cellular and genetic basis of PAH, researchers found that the onset of PAH before age 36 years was associated with the greatest likelihood of delayed disease recognition, especially in individuals with histories of common respiratory disorders. This article is published in the July issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians: Chest. 2011;140(1):19-26.


New research shows that indacaterol is effective and well tolerated for patients with moderate to severe chronic obstructive pulmonary disease (COPD). Researchers at the University Health Network, Asthma and Airway Centre, in Toronto, ON, Canada; the University of Nebraska Medical Center; and Novartis evaluated the safety and tolerability of indacaterol, a once-daily, inhaled β2-agonist, compared with a placebo in 415 patients with moderate to severe COPD. Over a 1-year period, researchers found that therapy with indacaterol led to significant reductions in COPD exacerbations and as-needed albuterol use, and it was well tolerated. This article is published in the July issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians: Chest. 2011;140(1):68-75.


Contact: Jennifer Stawarz
American College of Chest Physicians

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