Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism

doi:10.1371/journal.pone.0162483

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Title:	Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism
Authors:	Yeh, Jun-Jun Wang, Yu-Chiao Kao, Chia-Hung
Contributors:	Chia Yi Christian Hosp, Ditmanson Med Fdn Chia Nan Univ Pharm & Sci Meiho Univ China Med Univ Hosp, Management Off Hlth Data China Med Univ, Coll Med China Med Univ, Grad Inst Clin Med Sci, Coll Med China Med Univ Hosp, Dept Nucl Med China Med Univ Hosp, PET Ctr Asia Univ, Dept Bioinformat & Med Engn
Keywords:	population-based-cohort deep-vein thrombosis copd overlap endothelial dysfunction management metaanalysis prevalence biomarkers increases events
Date:	2016-09
Issue Date:	2018-01-18 11:40:57 (UTC+8)
Publisher:	Public Library Science
Abstract:	Purpose We conducted a cohort study to clarify this relationship between asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and pulmonary embolism (PE). Methods From the National Health Insurance Research Database of Taiwan, we identified patients who had a diagnosis of asthma and a diagnosis of COPD (defined as ACOS) and concurrent treatment between January 1999 and December 2009 (ACOS cohort: n = 14,150; non-ACOS cohort: n = 55,876). Cox proportional hazards regression analysis was performed to determine the adjusted hazard ratios (aHRs) for PE of the ACOS cohort compared with the non-ACOS cohort. Results Comparing the ACOS cohort with the non-ACOS cohort, the aHR of PE was 2.08 (95% confidence intervals [ CIs]: 1.56-2.76). The risk of PE was higher in ACOS cohort than non-ACOS cohort, regardless of age, sex, comorbidity, inhaled corticosteroids (ICSs) and oral steroids (OSs) used. For ages ranging from 20 to 65 years, the aHR of PE was 2.53 (95% CI: 1.44-4.44) in the ACOS cohort. ACOS patients using ICSs (aHR: 1.97, 95% CI: 1.29-3.01) or OSs (aHR: 1.97, 95% CI: 1.46-2.65), the risk of PE was higher than in the non-ACOS cohort. The risk of PE increased with the number of outpatient visits and hospitalizations necessitated, ranging from 2.32 (95% CI: 1.54-3.52) in patients having 3-9 visits to 4.20 (95% CI: 2.74-6.44) for those having > 9 visits. Conclusions ACOS is associated with increased risk of PE, particularly patients with a high frequency of AE-even in young adults or people without comorbidities.
Relation:	Plos One, v.11 n.9, e0162483
Appears in Collections:	[Dept. of Childhood Education and Nursery] Periodical Articles

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