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Pulmonary Artery Enlargement Predicts Exacerbation in COPD

Pulmonary artery enlargement has strongest link to severe exacerbations of all variables examined

For patients with COPD, CT measurement of pulmonary artery enlargement, as determined by a ratio of the diameter of the pulmonary artery to the diameter of the aorta (PA:A) of >1, correlates with severe exacerbations, according to a study published online Sept. 3 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the European Respiratory Society in Vienna.

J. Michael Wells, MD, from the University of Alabama at Birmingham, and colleagues conducted a multicenter observational trial involving former and current smokers with COPD to determine the association between a PA:A ratio of >1 and a history of severe exacerbations requiring hospitalization at the time of enrollment. The utility of the ratio was assessed as a predictor of events in longitudinal follow-up of this cohort and in an external validation cohort.

The researchers observed a significant association between a PA:A ratio of >1 and a history of severe exacerbations (odds ratio, 4.78). In both the trial cohort and the external validation cohort, a PA:A ratio of >1 correlated independently with an increased risk of future severe exacerbations (odds ratio, 3.44 and 2.80, respectively). PA:A ratio of >1 had the strongest association with severe exacerbations of all the variables analyzed.

"Pulmonary artery enlargement (a PA:A ratio of >1), as detected by CT, was associated with severe exacerbations of COPD," Wells and colleagues conclude.

Several authors disclosed financial relationships with pharmaceutical and biotechnology companies.

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