- 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.
- 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.
- Meta-analysis and systematic review of 43 randomized controlled trials.
- Pooled RRs and 95% CIs calculated.
- Funding: Health Commission of Qinghai Province.
- Focused on stable COPD and ILABs; effects with exacerbations, short-acting drugs not assessed.
- Not all studies recorded all CV events.