Short-acting anticholinergic bronchodilation does not increase cardiovascular events in smokers with mild to moderate pulmonary obstruction.
Pubmed ID: 23278997
Journal: Respirology (Carlton, Vic.)
Publication Date: 05/01/2013
Affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
MeSH Terms: Humans, Male, Adult, Female, Cardiovascular Diseases, Risk Factors, Middle Aged, Smoking, Longitudinal Studies, Proportional Hazards Models, Treatment Outcome, Severity of Illness Index, Follow-Up Studies, Incidence, Survival Rate, Pulmonary Disease, Chronic Obstructive, Bronchodilator Agents, Cholinergic Antagonists
Authors: van Weel C, de Jong E, van Dijk WD, Heijdra Y, Lenders JW, Akkermans R, Schermer TR
Cite As: de Jong E, van Dijk WD, Heijdra Y, Lenders JW, van Weel C, Akkermans R, Schermer TR. Short-acting anticholinergic bronchodilation does not increase cardiovascular events in smokers with mild to moderate pulmonary obstruction. Respirology 2013 May;18(4):663-8.
BACKGROUND AND OBJECTIVE: We hypothesized that bronchodilation in patients with chronic obstructive pulmonary disease (COPD) increases the smoke-related risk to develop cardiovascular disease, and aimed to study the effect of short-acting anticholinergic bronchodilation and smoking on cardiovascular events. METHODS: We performed a secondary analysis on data from the Lung Health Study, a large randomized clinical trial of smokers with mild to moderate pulmonary obstruction, 35-60 years old, without cardiovascular comorbidity. We used Cox proportional survival analysis, controlling for several confounders, to study the effect on 5-year risk of fatal and/or non-fatal cardiovascular events. Secondary outcome encompassed fatal and non-fatal coronary events. RESULTS: Of 2745 participants, 23 (0.8%) died of cardiovascular disease. One hundred and sixty-two participants were hospitalized for a cardiovascular event, and 94 participants due to a coronary event. Survival analysis revealed no effect between smoking and short-acting anticholinergic bronchodilation on fatal and/or non-fatal cardiovascular events, hazard ratio = 1.12 (0.58-2.19), nor on coronary events, hazard ratio = 1.46 (0.60-3.56). CONCLUSIONS: Our study results show that short-acting anticholinergic bronchodilation had no detrimental effect on cardiovascular disease in smokers with mild to moderate pulmonary obstruction.