Effect of Bronchodilator and Steroid Use on Heart Disease and Stroke Risks in a Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap Cohort: A Propensity Score Matching Study

doi:10.3389/fphar.2019.01409

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Title:	Effect of Bronchodilator and Steroid Use on Heart Disease and Stroke Risks in a Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap Cohort: A Propensity Score Matching Study
Authors:	Yeh, Jun-Jun(葉俊濬) Yang, Yu-Cih Hsu, Chung Y. Kao, Chia-Hung
Contributors:	Chia Yi Christian Hosp, Dept Famiy Med, Ditmanson Med Fdn Chia Nan Univ Pharm & Sci, Dept Early Childhood Educ & Nursery China Med Univ, Coll Med China Med Univ Hosp, Management Off Hlth Data China Med Univ, Grad Inst Biomed Sci, Coll Med China Med Univ, Sch Med, Coll Med China Med Univ Hosp, Dept Nucl Med Asia Univ, Dept Bioinformat & Med Engn China Med Univ Hosp, Ctr Augmented Intelligence Healthcare
Keywords:	heart disease stroke bronchiectasis-chronic obstructive pulmonary disease overlap syndrome bronchodilator steroid
Date:	2019-11
Issue Date:	2020-07-29 13:51:17 (UTC+8)
Publisher:	FRONTIERS MEDIA SA
Abstract:	Background: To determine the effects of bronchodilator, steroid, and anti-arrhythmia drug use on the risk of heart disease/stroke (HDS) in patients with bronchiectasis-chronic obstructive pulmonary disease overlap syndrome (BCOS). Methods: We retrospectively enrolled patients with BCOS (BCOS cohort, n = 1,493) and patients without bronchiectasis and chronic obstructive pulmonary disease (COPD) (non-BCOS cohort, n = 5,972). The cumulative incidence of HDS was analyzed through Cox proportional regression. We calculated adjusted hazard ratios (aHRs) and their 95% confidence intervals (CIs) for HDS after adjustments for sex, age, comorbidities, long-acting beta 2-agonist or long-acting muscarinic antagonist (LABAs/LAMAs) use, short-acting beta 2-agonist or short-acting muscarinic antagonist (SABAs/SAMAs) use, oral steroid (OSs) or inhaled corticosteroid steroid (ICSs) use, and anti-arrhythmia drugs use. Results: The aHR (95% CI) for HDS was 1.08 (0.28-4.06) for patients using LAMAs compared with those not using drugs. Regarding drug use days, the aHRs (95% CIs) were 32.2 (1.79-773.0), 1.85 (1.01-3.39), and 31.1 (3.25-297.80) for those with recent SABAs use, past ICSs use, and past anti-arrythmia drugs use, respectively. Regarding cumulative drug dose, the aHRs (95% CIs) were 2.12 (1.46-3.10), 3.48 (1.13-10.6), 3.19 (2.04-4.99), 28.1 (1.42-555.7), 2.09 (1.32-3.29), 2.28 (1.53-3.40), and 1.93 (1.36-2.74) for those with a low dose of SABAs, medium dose of SABAs, low dose of SAMAs, low dose of ICSs, medium dose of ICSs, low dose of OSs, and medium dose of OSs, respectively. Conclusions: Compared with patients without bronchiectasis and COPD, BCOS patients with recent SABAs, past ICSs, and past anti-arrhythmia drugs use; a low or medium SABAs ICSs, and OSs dose; and a low SAMAs dose had a higher risk of HDS. LAMAs were not associated with HDS.
Relation:	Frontiers in Pharmacology, v.10, 1409
Appears in Collections:	[Dept. of Childhood Education and Nursery] Periodical Articles

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