Adding a Second Bronchodilator in COPD: A Meta-Analysis on the Risk of Specific Cardiovascular Serious Adverse Events of Tiotropium/Olodaterol Fixed-Dose Combination.

This study aimed to ascertain whether tiotropium/olodaterol (T/O) 5/5 μg fixed-dose combination (FDC) may modulate the risk of main cardiovascular outcomes in COPD patients enrolled in randomized controlled trials (RCTs). A meta-analysis (CRD42017070100) was performed by selecting RCTs reporting raw data from the database concerning the impact of T/O 5/5 µg FDC vs. monocomponents on the occurrence of specific cardiovascular serious adverse events: arrhythmia, heart failure, myocardial infarction, and stroke. Data were reported as relative risk and 95% Confidence Interval, and the risk of publication bias assessed via Egger's test. Eighty six full text articles were identified, and 10 RCTs published in 7 studies between 2015 and 2018 were included into the analysis. Data obtained from 12,690 COPD patients (44.47% T/O FDC, 55.53% monocomponents) were extracted. T/O 5/5 μg FDCs did not significantly modulate (p-value> 0.05) the risk of arrhythmia (1.02, 0.55 - 1.92), heart failure (0.88, 0.41 - 1.92), myocardial infarction (1.15, 0.70 - 1.87), and stroke (0.98, 0.44 - 2.16) vs. monocomponents. No significant publication bias affected the effect estimates of this meta-analysis. The results of this quantitative synthesis indicate that dual bronchodilation with T/O 5/5 μg FDC is characterized by an acceptable cardiovascular safety profile in COPD patients. PMID: 32252547 [PubMed - as supplied by publisher]
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - Category: Respiratory Medicine Tags: COPD Source Type: research

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Conclusion: BMI has a nonlinear relationship with 1-year unplanned readmission in patients with myocardial infarction. The 1-year unplanned readmission rate of overweight patients (BMI > 29.3 kg/m2) has increased significantly. Obesity paradox does not exist in terms of readmission of Chinese patients with myocardial infarction after PCI. PMID: 32148951 [PubMed]
Source: Cardiology Research and Practice - Category: Cardiology Authors: Tags: Cardiol Res Pract Source Type: research
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Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
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Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems COPD Source Type: research
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Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
The cardiovascular risk of concurrently using long-acting β2-agonists (LABAs) and anticholinergics (LAMAs) in COPD is uncertain. We assessed the comparative cardiovascular and cerebrovascular safety of adding a second long-acting bronchodilator in patients with COPD. We identified a cohort of COPD patients, new users of LABA or the LAMA tiotropium during 2002–2012, from the UK Clinical Practice Research Datalink. Using high-dimensional propensity scores, each patient adding a second bronchodilator was matched with a patient who remained on monotherapy. Patients were followed for 1 year for the occurrence of...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: COPD and smoking Original Articles: COPD Source Type: research
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Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Long-acting bronchodilators, including long-acting beta2-agonists (LABA) and the anticholinergic tiotropium, are recommended as initial maintenance treatment in COPD, though their risk on cardio-pulmonary events remains uncertain in real world settings. We assessed whether treatment initiation with tiotropium increases the risk of acute myocardial infarction (AMI), stroke, heart failure, arrhythmia and pneumonia, relative to a LABA.We identified all new users of a long-acting bronchodilator during 2002-2012, age 55 or older, from the United Kingdom's Clinical Practice Research Datalink. Each patient who initiated tiotropiu...
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Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 5.1 Airway Pharmacology and Treatment Source Type: research
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Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
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