Abstract

We investigated the association between the use of inhaled bronchodilators and the risk of AMI. A nested case-control study using the nationwide insurance claims database was conducted. Overall, 11,054 AMI cases and 47,815 matched (up to 1:5) controls were identified from 1,036,119 subjects without acute major cardiovascular events in the past year. Long-acting and short-acting β-agonists (LABAs and SABAs) were associated with increase in the risk of AMI, although an inhaled corticosteroid combined with a long-acting β-agonist was not. Long-acting muscarinic antagonists (LAMAs) in a dry powder inhaler (DPI) were significantly associated with reduced risk of AMI, while LAMAs in a soft mist inhaler (SMI) didn’t decrease the risk of it. In hypertensive or diabetic patients, LAMAs in a DPI were associated with reduced risk of AMI, but LABAs were associated with increased risk. Among the β-blocker users, the reduction of AMI risk by LAMAs was the most significant. In conclusions, inhaled β-agonists were associated with increase in the risk of AMI, while LABAs accompanied by ICSs were not associated with increase in the risk of AMI. LAMAs in a DPI use were associated with lower risk of AMI.

Details

Title
Inhaled bronchodilators and acute myocardial infarction: a nested case-control study
Author
Chang-Hoon, Lee 1   VIAFID ORCID Logo  ; Choi, Seongmi 2 ; Eun Jin Jang 3 ; Han-Mo, Yang 4 ; Ho Il Yoon 5 ; Yun Jung Kim 6 ; Kim, Jimin 7 ; Jae-Joon Yim 1 ; Kim, Deog Kyeom 8 

1  National Evidence-based Healthcare Collaborating Agency, Jung-Gu, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-Gu, Seoul, Republic of Korea 
2  National Evidence-based Healthcare Collaborating Agency, Jung-Gu, Seoul, Republic of Korea; Department of Statistics, College of Natural Sciences, Kyungpook National University, Buk-Gu, Daegu, Republic of Korea 
3  National Evidence-based Healthcare Collaborating Agency, Jung-Gu, Seoul, Republic of Korea; Department of Information Statistics, Colloge of Natural Science, Andong National University, Andong, Republic of Korea 
4  Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University Hospital, Jongno-Gu, Seoul, Republic of Korea 
5  National Evidence-based Healthcare Collaborating Agency, Jung-Gu, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea 
6  National Evidence-based Healthcare Collaborating Agency, Jung-Gu, Seoul, Republic of Korea 
7  National Evidence-based Healthcare Collaborating Agency, Jung-Gu, Seoul, Republic of Korea; Department of Health Policy and Hospital Management, Graduate School of Public Health, Korea University, Seongbuk-Gu, Seoul, Republic of Korea 
8  National Evidence-based Healthcare Collaborating Agency, Jung-Gu, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Dongjak-Gu, Seoul, Republic of Korea 
Pages
1-8
Publication year
2017
Publication date
Dec 2017
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-017-17890-1
ProQuest document ID
1983432443
Copyright
© 2017. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.