CHEST 2020

The CHEST Annual Meeting 2020 virtual event, held October 18-21, 2020, featured numerous educational sessions and lectures in pulmonary, critical care, and sleep medicine. Here are highlights from select presentations.

Aggressive management of ILD as a complication of idiopathic inflammatory myopathies can maintain lung function

Presenter: Hema Balina, MD

A single-center retrospective study suggests that aggressive management of idiopathic inflammatory myositis (IIM)-related interstitial lung disease (ILD) may preserve lung function and reduce the rate of death.

Current lung cancer screening guidelines may miss significant number of African Americans at risk

Presenter: Carol Velez Martinez, MD

Current lung cancer screening recommendations from the US Preventive Services Task Force (USPSTF) miss a significant portion of African Americans at risk of lung cancer, according to a single-institution chart review of new lung cancer diagnoses.1 As a result, newer individual risk-based prediction models for the use of low-dose computed tomography (CT) screening may be needed, especially at institutions that serve a large number of African Americans, who are at greater risk of lung cancer.

Switch to riociguat may benefit PAH patients not at treatment goal on PDE5 inhibitor

Presenter: Marius Hoeper, MD

In patients with intermediate-risk pulmonary arterial hypertension (PAH) who have an inadequate response to stable treatment with a phosphodiesterase-5 (PDE5) inhibitor, switching to riociguat results in greater clinical improvement compared with maintenance PDE5 inhibitor therapy.

Viral pneumonia severity score predicts outcomes in COVID-19 pneumonia

Presenter: Jurgena Tusha, MD

The recently developed MuLBSTA score, which incorporates six clinical parameters, predicts disease severity and overall outcomes in patients with COVID-19 pneumonia.

VTE risk score and bleeding risk score may inform thromboprophylaxis decision post-discharge

Presenter: Scott Woller, MD

In hospitalized medical patients, the risks of 90-day hospital-associated venous thromboembolism (HA-VTE) and hospital-associated major bleeding (HA-MB) can be estimated at the time of discharge through the use of a risk-estimation tool, based on ubiquitous laboratory values, to inform decisions on extended duration thromboprophylaxis, according to a model presented by Scott Woller, MD, from Intermountain Health Care, Murray, UT.

Benefit of phrenic nerve stimulation on central sleep apnea sustained to 5 years

Presenter: Shahrokh Javaheri, MD

At 5 years, patients with moderate to severe central sleep apnea who underwent transvenous phrenic nerve stimulation showed durability of improvements in the apnea-hypopnea index (AHI), sleep arousals, daytime sleepiness, and other outcomes.1 Further, 78% of patients were still alive at the 5-year follow-up, including 68% of those with heart failure, reported Shahrokh Javaheri, MD, from the Division of Pulmonary and Sleep Medicine, Bethesda North Hospital, Cincinnati, OH.

Author disclosures as indicated in the abstracts for these presentations.

Aggressive management of ILD as a complication of idiopathic inflammatory myopathies can maintain lung function:

Hema Balina disclosed no relevant relationships; Kevin Dsouza no disclosure on file; Pilar Acosta Lara disclosed financial interests (speaking) with Genentech; Tracy Luckhardt disclosed financial interest (speaking) with Boehringer Ingelheim; Tejaswini Kulkarni disclosed financial interests (speaker, investigator meeting) with Boehringer Ingelheim and committee membership with the American Thoracic Society; Swati Gulati disclosed no relevant relationships.

Current lung cancer screening guidelines may miss significant number of African Americans at risk:

Carol Velez Martinez, Aswani Thurlapati, Samina Hirani, Jade Abad, Kavitha Beedupalli, and Runhua Shi disclosed no relevant relationships; Samip Master, Richard Mansour, and Constance Cole no disclosure on file.

Switch to riociguat may benefit PAH patients not at treatment goal on PDE5 inhibitor:

Raymond Benza, Sung-A Chang, Frank Kleinjung, Karen Paraschin, Tomas Pulido, and Anton Vonk Noordegraaf disclosed no relevant relationships. Financial interests were disclosed by Paul Corris (advisory) with Bayer; J. Simon Gibbs (consultant, speaking) with Complexa, Acceleron, Actelion, Bayer, Pfizer, and GSK; Ekkehard Grünig (speaking, research grant) with Actelion/Janssen, Bayer/MSD, OMT, and GlaxoSmithKline; Marius Hoeper (consulting) with Acceleron, Actelion, Bayer AG, Janssen-Cilag, MSD, and Pfizer; Pavel Jansa (consulting) with Actelion, AOP Orphan, and MSD; James Klinger (grant, committee membership) with United Therapeutics and Bayer; David Langleben (speaking, consulting, committee membership) with Bayer, Janssen, Northern Therapeutics, and PhaseBio; Vallerie McLaughlin (consulting, research support) with Acceleron, Actelion, Bayer, Caremark, CiVi Biopharma, Reata Pharm, SonoVie, and United Therapeutics; Christian Meier (salary) with Bayer; Stephan Rosenkranz (board member, consulting, committee member, research support, speaking) with Abbott, Acceleron, Actelion, Bayer, BMS, Janssen, MSD, Novartis, Pfizer, United Therapeutics, and Vifor Pharma; Gerald Simonneau (advisory, speaking) with Actelion, Bayer, MSD; Carmine Dario Vizza (advisory, committee member) with Actelion, Bayer, MSD, Ferreer, GSK, and United Therapeutics. Hikmet Al-Hiti, Mikyung Chang, Hossein Ghofrani, Gisela Meyer, Jaquelina Ota-Arakaki, Andrew Peacock, and R White had no disclosure on file.

Viral pneumonia severity score predicts outcomes in COVID-19 pneumonia:

Jurgena Tusha, Verisha Khanam, Vesna Tegeltija, and Sarwan Kumar have disclosed no relevant relationships.

VTE risk score and bleeding risk score may inform thromboprophylaxis decision post-discharge:

​Scott Woller, Gregory Snow, James Lloyd, and Masarret Fazili, disclosed no relevant relationships. Scott Stevens disclosed financial interests (inactive research contract) with BMS-Pfizer; Joseph Bledsoe disclosed financial interests (consultant) with BD; and Benjamin Horne disclosed financial interests (research grant) with AstraZeneca, GlaxoSmithKline, CareCentra) and (intellectual property relationship) with Alluceo and CareCentra.

Benefit of phrenic nerve stimulation on central sleep apnea sustained to 5 years:

Shahrokh Javaheri disclosed financial interests (consultant) with Respicardia. Alan Schwartz disclosed financial interests (consulting) with Respicardia, Airflow Sleep, FRESCA, Invicta Medical, Itamar Medical, LivaNova, Nyxoah, Pulmodyne, (ownership) with Respimetrix, and (grant/research) with Respironics. William Abraham disclosed financial interests (consulting) with Respicardia. Sanjaya Gupta disclosed financial interests (speaking) with Medtronic, Boston Scientific, and Respicardia. Scott McKane and Robin Germany disclosed financial interests (salary) with Respicardia. Maria Rosa Costanzo disclosed financial interests (advisory and research support) with Respicardia.