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Lo Casto M, Marino S, Zammuto MM, Tomasello A, Benfante A, Scichilone N, Battaglia S. Patients with bronchiectasis have a lower combined risk of cardiovascular risk factors and cardiovascular comorbidity compared to patients with COPD. Respir Med 2024; 229:107683. [PMID: 38821218 DOI: 10.1016/j.rmed.2024.107683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/10/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
INTRODUCTION AND OBJECTIVES Chronic respiratory diseases are associated with an increased risk of cardiovascular diseases (CVD); however, it is unknown whether some respiratory diseases are at higher risk than others. In this perspective, head-to-head studies comparing bronchiectasis and chronic obstructive pulmonary disease (COPD) are encouraged. We explored whether the prevalence of cardiovascular risk factors (diabetes mellitus and hyperlipidemia) and cardiovascular comorbidity (systemic hypertension, ischemic heart diseases, cardiac arrhythmia, stroke) are different in these two diseases. METHODS The present retrospective case-control study aimed to compare patients with bronchiectasis with age and sex-matched individuals with COPD. A total of 63 patients with bronchiectasis and 63 with COPD were retained for analysis. RESULTS Patients with bronchiectasis had a lower risk of systemic hypertension (OR 0.42 (C.I. 0.20 to 0.87)) and diabetes mellitus (OR 0.28 (C.I. 0.09 to 0.81)). In contrast, ischemic heart diseases, cardiac arrhythmia, stroke, and hyperlipidemia did not differ between the two groups. Logistic regression analysis showed that age, male sex, and COPD remain independent risk factors for having at least one condition of a composite index including the above-mentioned CVD and CV risk factors. In detail, a patient with COPD has a risk of 4.648 times (C.I. 1.48 to 15.78) for having at least one CVD compared with a patient with bronchiectasis. CONCLUSIONS The current findings suggest that subjects with bronchiectasis may experience lower cardiovascular risk than those with COPD. Larger studies are needed to confirm this preliminary observation and its clinical implications.
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Affiliation(s)
| | | | | | | | - Alida Benfante
- PROMISE Department, University of Palermo, Palermo, Italy
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Choi H, Kim SH, Han K, Park TS, Park DW, Moon JY, Kim SH, Kim TH, Sohn JW, Yoon HJ, Lee H. Association between exercise and risk of cardiovascular diseases in patients with non-cystic fibrosis bronchiectasis. Respir Res 2022; 23:288. [PMID: 36258193 PMCID: PMC9580142 DOI: 10.1186/s12931-022-02202-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although cardiovascular comorbidities negatively impact survival in patients with bronchiectasis, there is limited evidence to recommend exercise in this population. We aimed to evaluate whether exercise habit changes are related to reduced cardiovascular disease risk and explore an optimal exercise amount. METHODS This study identified 165,842 patients with newly diagnosed bronchiectasis during 2010-2016 who underwent two health examinations and were followed up until December 2020. The exposure was the change in weekly habits of moderate- or vigorous-intensity physical activity between the two examinations, classified into non-exercisers and exercisers (further classified into new exercisers, exercise dropouts, and exercise maintainers). The amount of exercise was measured using metabolic equivalents of task (MET). The outcome was the incidence of myocardial infarction (MI) or stroke. RESULTS During a mean of 6.2 ± 2.1 follow-up years, 4,233 (2.6%) and 3,745 (2.3%) of patients with bronchiectasis had MI or stroke, respectively. Compared to non-exercisers, exercisers had a significantly lower risk of MI or stroke by 9-28% (p < 0.001 for both). Among exercisers, exercise maintainers showed the lowest risk of MI (adjusted hazard ratio [aHR], 0.72; 95% confidence interval [CI], 0.64-0.81) and stroke (aHR, 0.72; 95% CI, 0.64-0.82) compared to non-exercisers. Regarding exercise amount, a significant risk reduction was observed only in patients with bronchiectasis who exercised for ≥ 500 MET-min/wk. CONCLUSION Exercise was associated with a reduced risk of cardiovascular diseases in patients with bronchiectasis. In particular, the risk was lowest in exercise maintainers, and cardiovascular risk reduction was significant when exercising more than 500 MET-min/wk.
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Affiliation(s)
- Hayoung Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.,Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Sang Hyuk Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Tai Sun Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Dong Won Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ji-Yong Moon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang-Heon Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Tae-Hyung Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jang Won Sohn
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ho Joo Yoon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. .,Divsion of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, 04763, Seoul, Korea.
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Martinez‐Garcia MA, Sibila O, Aliberti S. Bronchiectasis: A pulmonary disease with systemic consequences. Respirology 2022; 27:923-925. [DOI: 10.1111/resp.14370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Miguel Angel Martinez‐Garcia
- Pneumology Department Hospital Universitario y Politécnico la Fe de Valencia Spain
- CIBERES de enfermedades respiratorias Instituto de salud Carlos III Madrid Spain
| | - Oriol Sibila
- CIBERES de enfermedades respiratorias Instituto de salud Carlos III Madrid Spain
- Pneumology Department Hospital Clinic, IDIBAPS Barcelona Spain
| | - Stefano Aliberti
- Department of Biomedical Sciences Humanitas University Milan Italy
- Respiratory Unit IRCCS Humanitas Research Hospital Milan Italy
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Martinez-Garcia MA, Bekki A, Beaupertuy T, Vergara AM. IS BRONCHIECTASIS ASSOCIATED WITH CARDIOVASCULAR DISEASE? Respir Med Res 2022; 81:100912. [DOI: 10.1016/j.resmer.2022.100912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/16/2022] [Indexed: 10/18/2022]
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Xu JF, Gao YH, Song YL, Qu JM, Guan WJ. Research advances and clinical management of bronchiectasis: Chinese perspective. ERJ Open Res 2022; 8:00017-2022. [PMID: 35415184 PMCID: PMC8995535 DOI: 10.1183/23120541.00017-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/22/2022] [Indexed: 11/20/2022] Open
Abstract
Bronchiectasis is a debilitating chronic suppurative airway disease that confers a substantial burden globally. Despite the notable prevalence, research on bronchiectasis in mainland China remains in its infancy. Nevertheless, there has been a significant leap in the quantity and quality of research, which has contributed to the ever-improving clinical practice. A nationwide collaborative platform has been established to foster multicentre studies, which will help increase the level of evidence further. Here, we summarise the status quo of clinical management and consider the research priorities for bronchiectasis that have been published previously. We also highlight the efforts of the Chinese medical communities to outline the core tasks that need to be addressed within the next decade. The remarkable progress made in bronchiectasis research has revolutionised clinical practice in mainland Chinahttps://bit.ly/3K8kQYr
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Yeh JJ, Lai MC, Yang YC, Hsu CY, Kao CH. Relationships Between Bronchodilators, Steroids, Antiarrhythmic Drugs, Antidepressants, and Benzodiazepines and Heart Disease and Ischemic Stroke in Patients With Predominant Bronchiectasis and Asthma. Front Cardiovasc Med 2022; 9:797623. [PMID: 35252385 PMCID: PMC8893278 DOI: 10.3389/fcvm.2022.797623] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/17/2022] [Indexed: 01/09/2023] Open
Abstract
ObjectiveWe investigated the effects of medication on heart disease and ischemic stroke (HDS) risk in patients with predominant bronchiectasis-asthma combination (BCAS).MethodsBCAS and non-BCAS cohorts (N = 588 and 1,118, respectively) were retrospectively enrolled. The cumulative incidence of HDS was analyzed using Cox proportional regression; propensity scores were estimated using non-parsimonious multivariable logistic regression. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for HDS were calculated, adjusting for sex, age, comorbidities, and medication {long- and short-acting β2 agonists and muscarinic antagonists (LABAs/SABAs and LAMAs/SAMAs), steroids [inhaled corticosteroid steroids (ICSs), oral steroids (OSs)], antiarrhythmics, antidepressants (fluoxetine), benzodiazepines (alprazolam, fludiazepam), statins and antihypertensive drugs (diuretics, cardioselective beta blockers, calcium channel blockers (CCBs) and angiotensin converting enzyme inhibitors (ACEi), angiotensin II blockers)}.ResultsCompared with the non-BCAS cohort, the BCAS cohort taking LABAs, SABAs, SAMAs, ICSs, OSs, antiarrhythmics, and alprazolam had an elevated HDS risk [aHRs (95% CIs): 2.36 (1.25–4.33), 2.65 (1.87–3.75), 2.66 (1.74–4.05), 2.53 (1.61–3.99), 1.76 (1.43–2.18), 9.88 (3.27–30.5), and 1.73 (1.15–2.58), respectively except fludiazepam 1.33 (0.73–2.40)]. The aHRs (95% CIs) for LABAs ≤ 30 days, DDDs <415, ICSs ≤ 30 days were 1.10 (0.38–3.15), 2.95 (0.22–38.8), 1.45 (0.76–2.77). The aHRs (95% CIs) for current and recent alprazolam were 1.78 (1.09–2.93) and 777.8 (1.34–451590.0); for current and past fludiazepam were 1.39 (0.75–2.59) and 1.29 (0.42–4.01) and for past alprazolam was 1.57 (0.55–4.46); respectively. The aHRs (95% CIs) for alprazolam >30 DDDs, fludiazepam >20 DDDs, ICSs ≦415 DDDs, and OSs DDDs ≦15 were 1.60 (0.78–3.29), 2.43 (0.90–6.55), 5.02 (1.76–14.3), and 2.28 (1.43–3.62), respectively.ConclusionThe bronchodilators, steroids, and antiarrhythmics were associated with higher risk of HDS, even low dose use of steroids. However, the current use of LABAs/ICSs were not associated with HDS. Benzodiazepines were relatively safe, except for current or recent alprazolam use. Notably, taking confounders into account is crucial in observational studies.
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Affiliation(s)
- Jun-Jun Yeh
- Department of Family Medicine, Chest Medicine, Geriatric Medicine and Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Mei-Chu Lai
- Department of Laboratory Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Yu-Cih Yang
- College of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Y. Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- *Correspondence: Chia-Hung Kao ;
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Méndez R, Feced L, Alcaraz-Serrano V, González-Jiménez P, Bouzas L, Alonso R, Martínez-Dolz L, Hervás D, Fernández-Barat L, Torres A, Menéndez R. Cardiovascular Events during and after Bronchiectasis Exacerbations and Long-Term Mortality. Chest 2021; 161:629-636. [PMID: 34656526 DOI: 10.1016/j.chest.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Population-based and retrospective studies have shown that risk for cardiovascular events such as arrythmias, ischemic episodes or heart failure, increase during and after bronchiectasis exacerbations. RESEARCH QUESTION What are the risk factors for cardiovascular events (CVE) during and after bronchiectasis exacerbations and its impact on mortality? STUDY DESIGN AND METHODS This was a post-hoc retrospective analysis of a prospective observational study of 250 patients with bronchiectasis at two tertiary care hospitals. Only the first exacerbation was considered for each patient, collecting demographic, comorbidity, and severity data. The main outcomes were the appearance of CVE and mortality. Risk factors for CVE were analyzed using a semi-competing risks model. RESULTS During a median follow-up of 35 months, 74 (29.6%) patients had a CVE and 93 (37.2%) died. Semi-competing risks analysis indicated that age, arterial hypertension, chronic obstructive pulmonary disease, and potentially the severe exacerbations significantly increased the risk for developing CVE. Compared to patients without CVE, those with CVE had higher mortality. INTERPRETATION Demographic factors and comorbidities are risk factors for the development of CVE after an acute exacerbation of bronchiectasis. The appearance of CVE worsens long-term prognosis.
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Affiliation(s)
- Raúl Méndez
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain.
| | - Laura Feced
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain; University of Valencia. Valencia, Spain
| | - Victoria Alcaraz-Serrano
- Pneumology Department. University Hospital Clínic of Barcelona. August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Barcelona, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES). Madrid, Spain
| | - Paula González-Jiménez
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain; University of Valencia. Valencia, Spain
| | - Leyre Bouzas
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain
| | - Ricardo Alonso
- Laboratory Department. La Fe University and Polytechnic Hospital. Valencia, Spain
| | - Luis Martínez-Dolz
- Cardiology Department. La Fe University and Polytechnic Hospital. Health Research Institute La Fe. Valencia, Spain; Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV). Madrid, Spain
| | - David Hervás
- Data Science, Biostatistics & Bioinformatics. Health Research Institute La Fe. Valencia, Spain; Department of Applied Statistics and Operational Research and Quality. Universitat Politècnica de València. Valencia, Spain
| | - Laia Fernández-Barat
- Pneumology Department. University Hospital Clínic of Barcelona. August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Barcelona, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES). Madrid, Spain
| | - Antoni Torres
- Pneumology Department. University Hospital Clínic of Barcelona. August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Barcelona, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES). Madrid, Spain
| | - Rosario Menéndez
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain; University of Valencia. Valencia, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES). Madrid, Spain
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Liu Y, Huang X, Chen D, Chen F, Mo C, Guo Y, Xie C, Liu G, Zeng H, Sun Y, Yang Z. The detrimental qualitative and quantitative alterations of circulating endothelial progenitor cells in patients with bronchiectasis. Respir Med 2020; 176:106270. [PMID: 33302144 DOI: 10.1016/j.rmed.2020.106270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Bronchiectasis is an independent risk factor for cardiovascular disease(CVD)and cardiac dysfunction. Endothelial progenitor cells (EPCs) play a crucial role in maintaining endothelial function, and is inversely correlated with cardiovascular risk factors or cardiac dysfunction. However, the relationship between EPCs and bronchiectasis is unknown. METHODS Twenty-nine patients with stable bronchiectasis and 15 healthy controls were recruited. Fasting venous blood were collected for determining circulating EPC number and activity as well as systemic inflammatory cytokines. RESULTS The number and migratory or proliferative activity of circulating EPCs in bronchiectasis patients were significantly reduced (p < 0.001). In high E-FACED group, the number of circulating EPCs evaluated by cell culture assay and EPC proliferation were decreased (p < 0.05). Similarly, the number and function of circulating EPCs were both reduced in low forced expiratory volume in 1 s (FEV1) or high mMRC group (p < 0.05). There was a significant correlation between circulating EPCs and bronchiectasis disease severity, according to the E-FACED score (p < 0.05), particularly to FEV1 (p < 0.05) and mMRC dyspnea score (p < 0.05). The count and activity of EPCs inversely correlated with hsCRP levels and IL-6 levels (p < 0.01). CONCLUSIONS Deficiencies in the number and function of circulating EPCs are present in patients with bronchiectasis. The changes are related to disease severity and may be partly attributed to systemic inflammation. The current findings may provide novel surrogate evaluation biomarkers and potential therapeutic target for bronchiectasis.
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Affiliation(s)
- Yangli Liu
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Xinyan Huang
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Dubo Chen
- Laboratory Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Fengjia Chen
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Chengqiang Mo
- Department of Urology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Yubiao Guo
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Canmao Xie
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Gexiu Liu
- Institute of Hematology, School of Basic Medicine, Jinan University, Guangzhou, 510632, PR China
| | - Haitao Zeng
- Center for Reproductive Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, PR China
| | - Yunwei Sun
- Guangzhou Development District Hospital, Guangzhou, 510730, Province Guangdong, PR China.
| | - Zhen Yang
- Division of Emergency Medicine, Department of Emergency Intensive Care Unit, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, PR China; NHC Key Laboratory on Assisted Circulation, Sun Yat-Sen University, Guangzhou, 510080, PR China.
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Yeh JJ, Yang YC, Hsu CY, Kao CH. 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. Front Pharmacol 2019; 10:1409. [PMID: 31849665 PMCID: PMC6895570 DOI: 10.3389/fphar.2019.01409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 11/05/2019] [Indexed: 01/14/2023] Open
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 β2-agonist or long-acting muscarinic antagonist (LABAs/LAMAs) use, short-acting β2-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.
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Affiliation(s)
- Jun-Jun Yeh
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,Department of Early Childhood Education and Nursery, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Cih Yang
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chung Y Hsu
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
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10
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Geake J, Bell SC. Bronchiectasis: Yet another systemic disease? Respirology 2018; 23:797-798. [PMID: 29717795 DOI: 10.1111/resp.13322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 04/16/2018] [Indexed: 11/29/2022]
Abstract
See related Article
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Affiliation(s)
- James Geake
- Department of Thoracic Medicine, Lyell McEwin Hospital, Adelaide, SA, Australia
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Scott C Bell
- Department of Thoracic Medicine, The Prince Charles Hospital, Brisbane, QLD, Australia
- Lung Bacteria Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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