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- W2550401731 abstract "Long-acting beta 2 -agonists (LABA) and the anticholinergic tiotropium are used extensively to treat COPD, but the cardiovascular safety of their concurrent use is uncertain. We conducted a population-based cohort study to evaluate whether adding a second long-acting bronchodilator increases the risk of acute myocardial infarction (AMI), stroke, heart failure and arrhythmia, relative to monotherapy. We identified new monotherapy users of a long-acting bronchodilator during 2002-2012, age 55 or older, from the United Kingdom9s Clinical Practice Research Datalink. Each patient who subsequently added the other long-acting bronchodilator was propensity score- and time-matched with a patient who remained on long-acting bronchodilator monotherapy. Patients were followed for one year for the occurrence of cardiovascular events. The cohorts included up to 31,174 concurrent bronchodilator users matched to up to 31,174 patients remaining on bronchodilator monotherapy. Adding a long-acting bronchodilator, compared to remaining on monotherapy, was not associated with an increased risk of AMI (hazard ratio (HR) 1.12; 95% CI: 0.92-1.36), stroke (HR 0.87; 95% CI: 0.69-1.10) or arrhythmia (HR 1.05; 95% CI: 0.81-1.36), but the risk was elevated for heart failure (HR 1.16; 95% CI: 1.03-1.30). The results were comparable when stratified by the addition of tiotropium to a LABA or vice-versa. In conclusion, the addition of a second long-acting bronchodilator in the real world setting treatment of COPD does not increase the risk of most cardiovascular events. The modest increase for heart failure may be due to residual confounding by indication and needs further investigation." @default.
- W2550401731 created "2016-11-30" @default.
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- W2550401731 date "2016-09-01" @default.
- W2550401731 modified "2023-09-27" @default.
- W2550401731 title "Concurrent use of long-acting bronchodilators in COPD and the risk of adverse cardiovascular events: A population-based study" @default.
- W2550401731 doi "https://doi.org/10.1183/13993003.congress-2016.pa993" @default.
- W2550401731 hasPublicationYear "2016" @default.
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