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
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,...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-11-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphar.2019.01409/full |
| _version_ | 1819108278100033536 |
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| author | Jun-Jun Yeh Jun-Jun Yeh Jun-Jun Yeh Yu-Cih Yang Yu-Cih Yang Chung Y. Hsu Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao |
| author_facet | Jun-Jun Yeh Jun-Jun Yeh Jun-Jun Yeh Yu-Cih Yang Yu-Cih Yang Chung Y. Hsu Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao |
| author_sort | Jun-Jun Yeh |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T03:07:21Z |
| format | Article |
| id | doaj.art-3816694da48041dca5e8080d25713445 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-22T03:07:21Z |
| publishDate | 2019-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-3816694da48041dca5e8080d257134452022-12-21T18:41:02ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122019-11-011010.3389/fphar.2019.01409456199Effect of Bronchodilator and Steroid Use on Heart Disease and Stroke Risks in a Bronchiectasis–Chronic Obstructive Pulmonary Disease Overlap Cohort: A Propensity Score Matching StudyJun-Jun Yeh0Jun-Jun Yeh1Jun-Jun Yeh2Yu-Cih Yang3Yu-Cih Yang4Chung Y. Hsu5Chia-Hung Kao6Chia-Hung Kao7Chia-Hung Kao8Chia-Hung Kao9Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, TaiwanDepartment of Early Childhood Education and Nursery, Chia Nan University of Pharmacy and Science, Tainan, TaiwanCollege of Medicine, China Medical University, Taichung, TaiwanCollege of Medicine, China Medical University, Taichung, TaiwanManagement Office for Health Data, China Medical University Hospital, Taichung, TaiwanGraduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, TaiwanGraduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, TaiwanDepartment of Nuclear Medicine, China Medical University Hospital, Taichung, TaiwanDepartment of Bioinformatics and Medical Engineering, Asia University, Taichung, TaiwanCenter of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, TaiwanBackground: 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.https://www.frontiersin.org/article/10.3389/fphar.2019.01409/fullheart diseasestrokebronchiectasis–chronic obstructive pulmonary disease overlap syndromebronchodilatorsteroid |
| spellingShingle | Jun-Jun Yeh Jun-Jun Yeh Jun-Jun Yeh Yu-Cih Yang Yu-Cih Yang Chung Y. Hsu Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao Chia-Hung Kao 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 Frontiers in Pharmacology heart disease stroke bronchiectasis–chronic obstructive pulmonary disease overlap syndrome bronchodilator steroid |
| 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | heart disease stroke bronchiectasis–chronic obstructive pulmonary disease overlap syndrome bronchodilator steroid |
| url | https://www.frontiersin.org/article/10.3389/fphar.2019.01409/full |
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