The effects of medications for treating COPD and allied conditions on stroke: a population-based cohort study

Autor: Ai-Ling Shen, Hsiu-Li Lin, Hsiu-Chen Lin, Jane Chen-Jui Chao, Chien-Yeh Hsu, Chung-Yu Chen
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: npj Primary Care Respiratory Medicine, Vol 32, Iss 1, Pp 1-7 (2022)
Druh dokumentu: article
ISSN: 2055-1010
DOI: 10.1038/s41533-021-00267-3
Popis: Abstract Patients with chronic obstructive pulmonary disease (COPD) are at higher risk of stroke. This study aimed to investigate the clinical factors of stroke risk in COPD and allied conditions patients and associations between medications for treating COPD and allied conditions. The population-based study cohort comprised 24,173 patients diagnosed with COPD and allied conditions between 2000 and 2013, and 24,170 selected matched patients without COPD comprised the comparison cohort from a nationwide database. Cox-proportional hazard regression was performed to determine the impact of medical therapies, comorbidities, and other clinical factors on stroke risk. Of the 48,343 included patients, 1394 (2.9%) experienced stroke during follow-up, with a significant difference between COPD and allied conditions cohort (1003/4.2%) and comparison cohort (391/1.6%) (adjusted hazard ratio [aHR]: 2.72, p 65 years) (HR: 1.06); male (HR: 1.39); with hypertension (HR: 1.46), diabetes mellitus (HR: 1.33) and atrial fibrillation (HR: 1.63) had increased stroke risk. Mucolytics (HR: 0.44) and combination therapy with inhaled corticosteroids (ICS) and long-acting β2-agonists (LABA) (HR: 0.75) were associated with decreased stroke risk in COPD and allied conditions patients. Among COPD and allied conditions patients, major comorbidities increase risk of stroke. Therapy with mucolytic agents and combination ICS/LABA is associated with risk reduction.
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