Cardiovascular Outcomes Among Patients with COPD Prescribed with LABA or LAMA: A Real-World Territory Wide Study.

IF 4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2025-10-18 DOI:10.1007/s12325-025-03375-5

Chun Ka Wong, Eugene C C Cheng, Ali Choo, Chung Ki Tsui, Audrey Tsznam Ko, Ting Fung Ma, Hung-Fat Tse, James Chung Man Ho, Wang Chun Kwok

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引用次数: 0

Abstract

Introduction: This study aims to compare cardiovascular outcomes among patients who received long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA) and thereby better inform the choice of pharmacotherapy prescription for patients with chronic obstructive pulmonary disease (COPD).

Method: A real-world territory-wide retrospective cohort study using electronic data patient databases in Hong Kong was conducted. Patients with COPD without cardiovascular disease who were new users of LABA or LAMA from public hospitals in Hong Kong between 2010 and 2019 were identified and were followed up for 3 years after treatment initiation. Incidences of cardiovascular events were compared. Propensity score matching was employed to match important patient characteristics and clinical features.

Results: After the propensity score matching, 5020 patients were included: 2510 treated with LABA and 2510 with LAMA. At 3-year follow-up, 19.6% of patients experienced cardiovascular events. LAMA treatment was associated with a higher incidence of cardiovascular events compared to LABA (20.2% vs 19.0%, adjusted hazard ratio [aHR] 1.14, p = 0.04). This difference was primarily driven by increased risks of new-onset atrial fibrillation (7.93% vs 6.53%, aHR 1.30, p = 0.01). Incidence rates were similar between groups for ventricular tachycardia and fibrillation (0.52% vs 0.80%, p = 0.32), acute coronary syndrome (4.06% vs 3.82%, p = 0.33), ischemic stroke (2.39% vs 2.59%, p = 0.98), and heart failure hospitalization (10.8% vs 9.84%, p = 0.05).

Conclusion: Patients with COPD treated with LAMA might have higher incidence of atrial fibrillation when compared with LABA but not other cardiovascular events.

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COPD患者服用LABA或LAMA的心血管结局：一项现实世界范围的研究

前言：本研究旨在比较长效β受体激动剂（LABA）和长效毒蕈碱拮抗剂（LAMA）治疗慢性阻塞性肺疾病（COPD）患者的心血管结局，从而更好地为慢性阻塞性肺疾病（COPD）患者的药物治疗处方选择提供信息。方法：利用香港的电子数据患者数据库进行了一项真实世界的区域性回顾性队列研究。2010年至2019年期间在香港公立医院新使用LABA或LAMA的无心血管疾病COPD患者，并在治疗开始后随访3年。比较两组的心血管事件发生率。倾向评分匹配用于匹配重要的患者特征和临床特征。结果：经倾向评分匹配后，纳入5020例患者：LABA组2510例，LAMA组2510例。在3年的随访中，19.6%的患者发生心血管事件。与LABA相比，LAMA治疗与更高的心血管事件发生率相关（20.2% vs 19.0%，校正风险比[aHR] 1.14, p = 0.04）。这种差异主要是由于新发房颤的风险增加（7.93% vs 6.53%, aHR 1.30, p = 0.01）。室性心动过速和房颤的发生率组间相似（0.52% vs 0.80%, p = 0.32），急性冠状动脉综合征（4.06% vs 3.82%, p = 0.33），缺血性卒中（2.39% vs 2.59%, p = 0.98），心力衰竭住院（10.8% vs 9.84%, p = 0.05）。结论：与LABA相比，LAMA治疗COPD患者心房颤动的发生率可能更高，但其他心血管事件的发生率不高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.