根据吸入器治疗和慢性阻塞性肺部疾病的并发症的心血管事件
Eun Kyung Kim1, Eunyoung Lee2, Ji Eun Park3
1Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
International journal of chronic obstructive pulmonary disease
|January 25, 2024
概括
对COPD的三重治疗增加了心脏衰竭和心律失常等心血管风险. 拉马/拉巴疗法与这些事件没有显著关联,这表明在三重吸入器治疗方案的患者中,应仔细考虑心血管风险.
科学领域:
- 肺部病理学 肺部病理学
- 心脏病学 心脏病学
- 药物治疗 药物治疗
背景情况:
- 慢性阻塞性肺病 (COPD) 经常与心血管共同疾病共存.
- 心血管并发症是COPD患者死亡的主要原因.
- 吸入器治疗是COPD管理的基石,需要对相关心血管事件风险进行调查.
研究的目的:
- 根据不同的吸入器疗法,研究COPD患者新心血管事件的发展.
- 分析特定的吸入器组合 (LAMA/LABA,ICS/LABA,三重疗法) 与心血管结果之间的关联.
- 评估伴随性疾病对接受吸入器治疗的COPD患者心血管事件发展的影响.
主要方法:
- 从韩国医疗保险审查和评估服务 (HIRA) 数据库中分析了一大群 (N = 199,772) 年龄≥40岁的COPD患者.
- 将患者分为三个治疗组:LAMA/LABA (N = 28,322),ICS/LABA (N = 11,812) 和三重疗法 (LAMA/ICS/LABA) (N = 6174) 的治疗组.
- 从指数日期到2020年12月31日的心血管事件发展的调查,使用多变量Cox分析.
主要成果:
- 与ICS/LABA相比,三重疗法 (LAMA/ICS/LABA) 与缺血性心脏病 (HR:1.22) 的风险增加,心力衰竭 (HR:1.45),心律失常 (HR:1.72) 和心房动/动 (HR:2.31) 的风险显著增加.
- 拉玛/拉巴疗法与这些心血管事件的发展没有显著的关联.
- 紧急诊所的访问独立地与缺血性心脏病,心力衰竭,心律不整以及心房/动 (p <0.05) 的更高风险有关.
结论:
- 接受三重吸入器治疗的COPD患者患有心血管事件的风险较高.
- 心血管风险评估对于COPD患者至关重要,特别是那些接受三重治疗的人,考虑到潜在的混因素.
- 这些发现强调了在治疗选择中需要平衡COPD症状控制与心血管安全.
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