COPD: inhaled long-acting bronchodilators aren’t linked to adverse CV outcomes

  • Int J Chron Obstruct Pulmon Dis

  • International Clinical Digest
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Takeaway

  • In patients with COPD, use of inhaled long-acting bronchodilators (ILABs) is not linked to cardiovascular (CV)-related adverse outcomes.
  • A long-acting beta-2-agonist (LABA) olodaterol was tied to reduced risk for events and formoterol specifically to decreased risk for cardiac ischemia.
  • Some hint at increased risk for heart failure with LABAs.

Why this matters

  • Some studies have addressed CV safety with ILABs in patients with COPD, but this study looks at risks for specific CV conditions.

Key results

  • No increase in CV adverse events with ILAB use.
  • Relative risk (RR) for hypertension with LABA use: 0.73 (95% CI, 0.55-0.98).
  • RR for overall CV events with olodaterol: 0.65 (95% CI, 0.49-0.88), but with loss of protection against hypertension.
  • RR for cardiac ischemia with formoterol: 0.53 (95% CI, 0.32-0.91).
  • Increased RR for heart failure with LABA: 1.71 (95% CI, 1.04-2.84), but not for any specific LABA.

Study design

  • Meta-analysis and systematic review of 43 randomized controlled trials.
  • Pooled RRs and 95% CIs calculated.
  • Funding: Health Commission of Qinghai Province.

Limitations

  • Focused on stable COPD and ILABs; effects with exacerbations, short-acting drugs not assessed.
  • Not all studies recorded all CV events.