GOLD 2017 on the way to a phenotypic approach? Analysis from the Phenotypes of COPD in Central and Eastern Europe (POPE) Cohort.

The distribution of patients based on exacerbations solely is the most profound consequence of the 2017 GOLD Report http://ow.ly/4UJa309fLbM

Recommendations for the management of patients with obstructive sleep apnoea and hypertension.

This article is aimed at addressing the current state-of-the-art in epidemiology, pathophysiology, diagnostic procedures and treatment options for appropriate management of obstructive sleep apnoea (OSA) in cardiovascular (in particular hypertensive) patients, as well as for the management of cardiovascular diseases (in particular arterial hypertension) in OSA patients. The present document is the result of work performed by a panel of experts participating in the European Union COST (Cooperation in Scientific and Technological research) Action B26 on OSA, with the endorsement of the European Respiratory Society and the European Society of Hypertension. In particular, these recommendations …

Positive Airway Pressure Treatment Reduces Glycated Hemoglobin (HbA1c) Levels in Obstructive Sleep Apnea Patients: Longitudinal Data from the Esada

European-Respiratory-Society (ERS) International Congress -- SEP 28-OCT 02, 2019 -- Madrid, SPAIN

LATE-BREAKING ABSTRACT: Phenotypes of COPD in central and Eastern Europe - The POPE study

Introduction: Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries. However, data regarding symptom load and clinical phenotypes of patients with COPD in CEE remain largely unknown. Methods: Participation in the POPE Study (a multicentre, observational cross-sectional survey) was offered to consecutive outpatients with stable COPD in 11 CEE countries if they fulfilled the following criteria: age ≥ 40 years, smoking history ≥ 10 pack-years, post-bronchodilator (BD) FEV 1 /FVC Results: 3504 patients (66 ± 8.7 yrs, 69% male, post-BD FEV 1 53.0 ± 17.5% predicted, Charlson comorbidity index 2.0 ± 1.4, and 1.2 ± 1.6 exacerb…

CAT in COPD phenotypes (POPE study)

Background: The COPD assessment test (CAT) is widely used for basic symptom evaluation in patients with COPD. The impact of COPD phenotypes on symptom scores using the CAT, however, remains largely unknown. Methods: The POPE-Study (NCT02119494) is an international, multicentre, observational cross-sectional survey of consecutive patients with COPD in Central and Eastern Europe (CEE). Respiratory symptoms using the modified Medical Research Council (mMRC) dyspnoea scale, and the CAT were recorded. Inclusion criteria: age ≥ 40 years, smoking history ≥ 10 pack-years, post-bronchodilator (BD) FEV1/FVC Results: 3366 COPD subjects (66 ± 8.8 yrs, post-BD FEV1 52.8 ± 18.5 % predicted, CAT 17.4 ± 7.…

Smoking and small, dense low-density lipoproteins.

Relationship Between the Apolipoprotein E Genotype and LDL Particle Size in Patients With Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is associated with dyslipidemia and increased cardiovascular risk. We assessed the effects of apolipoprotein E ( APOE) genotype on low-density lipoprotein (LDL) and high-density lipoprotein (HDL) particle size and lipid subclasses (separated by gradient gel electrophoresis) in patients with OSA. Stable patients (n = 181) prospectively recruited underwent full polysomnography. Both LDL particle size and LDL I proportion were reduced from ∊3∊3 homozygotes to ∊2 carriers and to ∊4 carriers (analysis of variance: P = .024; P = .040, respectively); carriers of the ∊4 allele of the APOE genotype had significantly lower LDL particle size and LDL I proportion compared…

Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: the POPE Study.

Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries; however, there are no data regarding clinical phenotypes of these patients in this region.Participation in the Phenotypes of COPD in Central and Eastern Europe (POPE) study was offered to stable patients with COPD in a real-life setting. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria. Secondary aims included analysis of differences in symptom load, comorbidities and pharmacological treatment.3362 patients with COPD were recruited in 10 CEE countries. 63% of the population were nonexacerbators, 20.4% frequen…

Therapy with non-invasive ventilation in patients with obstructive sleep apnoea: effects on atherogenic lipoprotein phenotype.

Patients with obstructive sleep apnoea are at increased risk of atherosclerotic morbidity and mortality. Abnormalities in lipid metabolism that occur in response to chronic intermittent hypoxia in patients with sleep-disordered breathing may increase the cardiovascular risk in an already susceptible population. Atherogenic lipoprotein phenotype and small, dense LDL have an independent predictive role for future cardio- and cerebro-vascular events in patients with the metabolic syndrome. Therefore, testing the hypothesis that therapy of obstructive sleep apnoea may reduce atherogenic lipoprotein phenotype might have significant clinical implications. We suggest that abolition of obstructive …

THE EUROPEAN SLEEP APNOEA DATABASE (ESADA) -- Report from 22 European Sleep Laboratories

The European Sleep Apnoea Database (ESADA) reflects a network of 22 sleep disorder centres in Europe enabled by a COST action B26 programme. This ongoing project aims to describe differences in standard clinical care of patients with obstructive sleep apnoea (OSA) and to establish a resource for genetic research in this disorder. Patients with suspected OSA are consecutively included and followed up according to local clinical standards. Anthropometrics, medical history, medication, daytime symptoms and sleep data (polysomnography or cardiorespiratory polygraphy) are recorded in a structured web-based report form. 5,103 patients (1,426 females, mean±SD age 51.8±12.6 yrs, 79.4% with apnoea/h…

Size and subclasses of low-density lipoproteins in patients with obstructive sleep apnea.

Patients with obstructive sleep apnea (OSA) have proatherogenic dyslipidemia. We analyzed predictors of low-density lipoproteins' (LDLs) size in patients with OSA. In a cross-sectional study including 58 participants with OSA (30 without the metabolic syndrome [MetS] and 28 with MetS), we evaluated the size of LDL by gradient gel electrophoresis. Compared with patients without the MetS, those with MetS showed lower LDL size ( P = .007), due to a reduction in large LDL-I particles ( P = .002) and an increase in small, dense LDL-IIIA ( P = .048) and LDL-IIIB ( P = .037). The size of LDL correlated inversely with age ( r = −.268, P = .042) and serum triglycerides ( r = −.364, P = .005), and p…

Severity Of Sleep Disordered Breathing Is An Independent Predictor Of Glycemic Health: The European Sleep Cohort (ESADA) Study

Determinants of CAT (COPD Assessment Test) scores in a population of patients with COPD in central and Eastern Europe: The POPE study

Abstract Background The COPD Assessment Test (CAT) has been proposed to help guide therapy in chronic obstructive pulmonary disease (COPD). It is important to understand the distribution of scores in different COPD populations and their determinants. Methods The POPE study is an international, observational cross-sectional study of COPD subjects in 11 Central and Eastern European countries aimed at characterizing COPD phenotypes. Here we report the analysis of CAT scores with the objective of identifying their determinants, evaluating symptom load and investigating the distribution of scores among the participating countries. Additionally, we investigated the discrepancies between the CAT a…

Fixed But Not Autoadjusting Positive Airway Pressure Attenuates the Time-dependent Decline in Glomerular Filtration Rate in Patients With OSA

Abstract: BACKGROUND: The impact of treating OSA on renal function decline is controversial. Previous studies usually included small samples and did not consider specific effects of different CPAP modalities. The aim of this study was to evaluate the respective influence of fixed and autoadjusting CPAP modes on estimated glomerular filtration rate (eGFR) in a large sample of patients derived from the prospective European Sleep Apnea Database cohort. METHODS: In patients of the European Sleep Apnea Database, eGFR prior to and after follow-up was calculated by using the Chronic Kidney Disease-Epidemiology Collaboration equation. Three study groups were investigated: untreated patients (n = 14…

Pharmacotherapy of COPD in Central and Eastern Europe - The POPE study

Introduction: In Central and Eastern Europe (CEE) the burden of chronic obstructive pulmonary disease (COPD) is high. It remains unknown whether patients are treated in line with GOLD recommendations or according to their phenotypes. Our aim was to analyze the treatment patterns of COPD in CEE. Methods: In the frame of the POPE study (ClinicalTrials.gov - NCT02119494) data including pharmacotherapy were collected in patients with stable COPD across 11 CEE countries. Results: 3366 patients (66±9 yrs, 70% male, FEV 1 53±18%) participated in the study. In all GOLD categories, the most widely used medications were long-acting beta-2 agonists (LABA), followed by long-acting antimuscarinic agents…