American College of Chest Physicians, Oct. 19-22

The annual meeting of the American College of Chest Physicians was held this year from Oct. 19 to 22 in Chicago, hosting participants from around the world, including specialists and heath care professionals focused on pulmonary medicine, critical care, and sleep medicine. The conference featured presentations focusing on clinical updates in thoracic medicine.

In one study, Anika Chowdhury, M.D., of Shaheed Suhrawardy Medical College and Hospital in Dhaka, Bangladesh, and colleagues found that esmolol appears to be the most effective beta blocker for improving survival and clinical outcomes in patients with septic shock.

The authors performed a comprehensive Bayesian network meta-analysis of eight randomized controlled trials (916 participants) and found that esmolol ranked highest for improving outcomes in adults with septic shock, including a decrease in 28-day mortality (hazard ratio, 0.47; surface under the cumulative ranking curve, 99 percent), intensive care unit mortality (hazard ratio, 0.54; surface under the cumulative ranking curve, 91 percent), heart rate (–18 bpm), and serum lactate, as well as shorter hospital stay. Meanwhile, landiolol was less effective across outcomes.

“Esmolol may serve as an adjunctive therapy in septic shock, especially in patients with high sympathetic drive,” Chowdhury said. “However, further large-scale trials are needed to confirm safety, efficacy, and integration into sepsis protocols before routine use.”

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In another study, Cosmo Fowler, M.D., of Piedmont Hospital in Atlanta, and colleagues found that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) offer a greater mortality risk reduction in patients with type 2 diabetes who also have obstructive sleep apnea (OSA).

Using the TriNetX U.S. Collaborative Network, the authors evaluated claims and electronic health records for 120 million patients from 69 health care organizations. They found that patients with type 2 diabetes and OSA prescribed GLP-1 RAs had lower one-year mortality compared with patients with type 2 diabetes and OSA not prescribed GLP-1 RAs.

“OSA may represent an effect modifier for survival in patients prescribed a GLP-1 RA — this might be explained by the notion that OSA is an independent mortality risk factor and GLP-1 RA prescription may specifically mitigate this, in addition to other well-studied benefits,” Fowler said. “While further research is needed and limitations to this study include its retrospective nature, these findings drawn from real-world patient data suggest GLP-1 RA prescription may provide a survival advantage that is specific to patients with a diagnosis of OSA.”

Several authors disclosed financial ties to Ferring, Idorsia, Merck, Huxley, and Zoll.

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