Oral corticosteroid use and the risk of acute myocardial infarction in chronic obstructive pulmonary disease.

Canadian Respiratory Journal : Journal of the Canadian Thoracic Society
L HuiartS Suissa

Abstract

Given the limited efficacy of oral corticosteroids in treating chronic obstructive pulmonary disease (COPD), the possible cardiac side effects of oral corticosteroids are of particular concern in an elderly population. The impact of the use of oral corticosteroids on the risk of acute myocardial infarction (AMI) in a cohort of patients with COPD was studied. The Saskatchewan health services databases were used to form a population-based cohort of 5648 patients aged 55 years or older who received a first treatment for COPD between 1990 and 1997. A nested case-control analysis was conducted: 371 cases presenting with a first myocardial infarction were matched with 1864 controls according to the length of follow-up, the date of cohort entry and age. Conditional logistic regression was used to adjust for sex, severity of COPD, systemic hypertension, diabetes and prior cardiovascular disease. Only the current use of corticosteroids was associated with an increased risk of AMI (adjusted RR=2.01 [95% CI 1.13 to 3.58]), particularly when the current dose was larger than 25 mg/day of prednisone or the equivalent (adjusted RR=3.22 [95% CI 1.42 to 7.34]). This observed increase in risk rapidly returned to baseline after the cessation of t...Continue Reading

Citations

Sep 2, 2011·Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia·Ana Maria Baptista MenezesUNKNOWN Grupo de Trabalho do Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas
Jun 22, 2019·Respirology : Official Journal of the Asian Pacific Society of Respirology·Mette ReilevJesper Hallas
Aug 4, 2012·The Journal of Rheumatology·Elena BartoloniRoberto Gerli
Oct 2, 2012·American Journal of Epidemiology·Laurence S Magder, Michelle Petri
Apr 12, 2014·BioMed Research International·Cheryl R Laratta, Stephan van Eeden
May 13, 2020·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Chrissa SiokaVasiliki Kostadima
Apr 18, 2009·Respiratory Medicine·Stephanie C MansonCarlos Fernandez Vidaurre

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