Int J Chron Obstruct Pulm Dis

COPD: Does triple inhaler therapy pose greater cardiovascular risks than double therapy?

February 27, 2024

COPD inhaler triple-therapy (LAMA/ICS/LABA) was linked with development of cardiovascular events (ischemic heart disease, heart failure, arrhythmia, stroke) compared with double therapy (ICS/LABA), in this Korean database cohort study of patients with various comorbidities. However, validation is required in light of confounding bias related to between-group differences.

• Database records on 46,308 COPD patients aged 40 years or older were examined for development of cardiovascular events. The cohort was divided by COPD therapy: long-acting muscarinic antagonist/long-acting beta-2 agonist (LAMA/LABA), inhaled corticosteroid (ICS)/LABA, and triple therapy (LAMA/ICS/LABA). In this cohort, 46% had hypertension, 23% had diabetes mellitus, and 47% had a Charlson Comorbidity index score ≥3.
• Development of ischemic heart disease was significantly higher in the triple-therapy group (4.3%) vs. the LAMA/LABA group (3.7%) or the ICS/LABA group (3.1%). Development of arrhythmias (eg, atrial fibrillation/flutter), heart failure, and ischemic stroke were also higher in the triple-therapy group. Incidence of ischemic heart disease, heart failure, and arrhythmia appeared higher in the first year of triple therapy; event frequency decreased with longer duration of therapy.
• No differences were seen between LAMA/LABA and ICS/LABA groups.

Source:

Kim EK, et al. (2024, January 19). Int J Chron Obstruct Pulmon Dis. Cardiovascular Events According to Inhaler Therapy and Comorbidities in Chronic Obstructive Pulmonary Disease. https://pubmed.ncbi.nlm.nih.gov/38269030/