Major comorbidities lead to the risk of adverse cardiovascular events in chronic obstructive pulmonary disease patients using inhaled long-acting bronchodilators: A case-control study
Journal
BMC Pulmonary Medicine
Journal Volume
19
Journal Issue
1
Pages
233
Date Issued
2019
Author(s)
Abstract
Background: While inhaled bronchodilators reduce symptoms and acute exacerbations of chronic obstructive pulmonary disease (COPD), their use is associated with increased cardiovascular events in some studies. This study investigates the risk of adverse events associated with the use of inhaled bronchodilators in COPD patients with multimorbidity. Methods: A case-control study was conducted between January 2015 and December 2017, and patients with spirometry-confirmed diagnosis of COPD (N = 1565) using inhaled long-acting bronchodilators were enrolled. Medical records were reviewed and clinical data, including age, gender, smoking status, major comorbidities, lung function stage, history of exacerbations, bronchodilator regimens, and treatment duration were analyzed. Major adverse cardiovascular events occurring during long-acting bronchodilator use were recorded. Results: The most common comorbidities were cardiovascular disease (CVD) (53.6%) and chronic kidney disease (CKD) (25.8%). We observed that CVD (odds ratio [OR], 5.77), CKD (OR, 2.02) and history of frequent exacerbations (OR, 2.37) were independent risk factors for cardiovascular events, regardless of the type of bronchodilators use. Moreover, COPD patients with both CKD and CVD had higher risk (6.32-fold) of adverse cardiovascular effects than those with neither comorbidity. Eighty-seven of 1565 (5.56%) COPD patients died during this study period. Of them, 21.8% (19/87) were cardiovascular-related and 73.6% (64/87) patients were respiratory-related mortality. Among COPD patients using long-acting bronchodilators, CKD was the only risk factor to predict cardiovascular events and cardiovascular-related mortality (OR, 4.87; 95% confidence interval [CI], 1.75-13.55]. Conclusions: COPD patients had higher risk of cardiovascular events were associated with their CVD and/or CKD comorbidities and history of frequent exacerbations, rather than associated with their use of inhaled bronchodilators. ? 2019 The Author(s).
SDGs
Other Subjects
bronchodilating agent; budesonide; budesonide plus formoterol; fluticasone propionate plus salmeterol; glycopyrronium bromide plus indacaterol; long acting drug; olodaterol; respimat; tiotropium bromide; umeclidinium plus vilanterol; bronchodilating agent; adult; age distribution; aged; Article; cardiovascular disease; cardiovascular risk; case control study; chronic kidney failure; chronic obstructive lung disease; comorbidity; controlled study; diabetes mellitus; disease association; disease exacerbation; female; forced expiratory volume; forced vital capacity; human; hypertension; lung function; major adverse cardiac event; major clinical study; male; mortality rate; risk assessment; risk factor; sex difference; smoking habit; spirometry; treatment duration; university hospital; very elderly; cardiovascular disease; chronic obstructive lung disease; complication; inhalational drug administration; middle aged; Administration, Inhalation; Adult; Aged; Aged, 80 and over; Bronchodilator Agents; Cardiovascular Diseases; Case-Control Studies; Female; Humans; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Risk Assessment
Publisher
BioMed Central Ltd.
Type
journal article