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    標題: Association of asthma-chronic obstructive pulmonary disease overlap syndrome with coronary artery disease, cardiac dysrhythmia and heart failure: a population-based retrospective cohort study
    作者: Yeh, Jun-Jun
    Wei, Yu-Feng
    Lin, Cheng-Li
    Hsu, Wu-Huei
    貢獻者: Chia Yi Christian Hosp,Ditmanson Med Fdn, Dept Chest Med Family Med & Geriatr Med
    Meiho Univ
    Chia Nan Univ Pharm & Sci
    Heng Chun Christian Hosp
    I Shou Univ, E Da Hosp, Dept Internal Med
    China Med Univ Hosp, Management Off Hlth Data
    China Med Univ, Coll Med
    China Med Univ, Coll Med, Grad Inst Clin Med Sci
    China Med Univ, Coll Med, Sch Med
    China Med Univ Hosp, Dept Internal Med, Div Pulm & Crit Care Med
    關鍵字: Systemic Inflammation
    Beta-Blockers
    Copd
    Impact
    Exacerbations
    Outcomes
    Comorbidities
    Hypertension
    Carvedilol
    Mortality
    日期: 2017-10
    上傳時間: 2018-11-30 15:49:59 (UTC+8)
    出版者: Bmj Publishing Group
    摘要: Objectives Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and cardiovascular diseases (CVDs) share common risk factors. However, the association between ACOS and the incidence of CVDs has not been reported. This study investigated the relationship between CVDs and ACOS in the general population. Setting Data were obtained from Taiwan's National Health Insurance Research Database for the period 2000 to 2010. Participants The ACOS cohort comprised patients (n= 5814) who had received a diagnosis of asthma and COPD. The non-ACOS cohort comprised patients who had not received a diagnosis of asthma or COPD and were matched to the ACOS cohort (2:1) by age, sex and index date (n= 11 625). Primary and secondary outcome measures The cumulative incidence of CVDs-coronary artery disease (CAD), cardiac dysrhythmia (CD) and heart failure (HF)-was calculated. Cox proportional regression analysis was employed to examine the relationship between ACOS and CVDs. Results After adjustment for multiple confounding factors-age, sex, comorbidities and medications-patients with ACOS were associated with a significantly higher risk of CVDs; the adjusted HRs (aHRs; 95% CI) for CAD, CD and HF were 1.62 (1.50 to 1.76), 1.44 (1.30 to 1.61) and 1.94 (1.73 to 2.19), respectively, whereas those of beta-blockers treatment for CAD, CD and HF were 1.19 (0.92 to 1.53), 0.90 (0.56 to 1.45) and 0.82 (0.49 to 1.38). The aHR of atenolol treatment for CD was 1.72 (1.01 to 2.93). The aHRs (95% CIs) of ACOS without acute exacerbation of COPD (AE-COPD) for CAD, CD and HF were 1.85 (1.70 to 2.01), 1.57 (1.40 to 1.77) and 2.07 (1.82 to 2.35), respectively. Conclusion ACOS was associated with higher CVD risk, even without the presence of previous comorbidities or AE-COPD. No significant differences in CVD events were observed in the ACOS cohort using beta-blockers, except for those using atenolol for treating CD.
    關聯: BMJ Open, v.7, n.10, e017657
    Appears in Collections:[嬰幼兒保育系] 期刊論文

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