Increased Risk of Sudden Cardiac Arrest in Obstructive Pulmonary Disease: A Case-Control Study

被引:17
作者
Warnier, Miriam Jacoba [1 ,2 ]
Blom, Marieke Tabo [3 ]
Bardai, Abdennasser [3 ,4 ]
Berdowksi, Jocelyn [5 ]
Souverein, Patrick Cyriel [1 ]
Hoes, Arno Wilhelmus [2 ]
Rutten, Frans Hendrik [2 ]
de Boer, Anthonius [1 ]
Koster, Rudolph Willem [5 ]
De Bruin, Marie Louise [1 ,2 ]
Tan, Han Liong [3 ,5 ]
机构
[1] Univ Utrecht, Utrecht Inst Pharmaceut Sci, Div Pharmacoepidemiol & Clin Pharmacol, Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Ctr Heart, NL-1105 AZ Amsterdam, Netherlands
[4] Interuniv Cardiol Inst Netherlands, Utrecht, Netherlands
[5] Univ Amsterdam, Acad Med Ctr, Dept Cardiol, NL-1105 AZ Amsterdam, Netherlands
关键词
CARDIOVASCULAR MORTALITY; BETA-BLOCKERS; HEART-RATE; ASTHMA; DEATH; DETERMINANTS; SURVIVAL; AGONISTS; SAFETY; COPD;
D O I
10.1371/journal.pone.0065638
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: We aimed to determine whether (1) patients with obstructive pulmonary disease (OPD) have an increased risk of sudden cardiac arrest (SCA) due to ventricular tachycardia or fibrillation (VT/VF), and (2) the SCA risk is mediated by cardiovascular risk-profile and/or respiratory drug use. Methods: A community-based case-control study was performed, with 1310 cases of SCA of the ARREST study and 5793 age, sex and SCA-date matched non-SCA controls from the PHARMO database. Only incident SCA cases, age older than 40 years, that resulted from unequivocal cardiac causes with electrocardiographic documentation of VT/VF were included. Conditional logistic regression analysis was used to assess the association between SCA and OPD. Pre-specified subgroup analyses were performed regarding age, sex, cardiovascular risk-profile, disease severity, and current use of respiratory drugs. Results: A higher risk of SCA was observed in patients with OPD (n = 190 cases [15%], 622 controls [11%]) than in those without OPD (OR adjusted for cardiovascular risk-profile 1.4 [1.2-1.6]). In OPD patients with a high cardiovascular risk-profile (OR 3.5 [2.7-4.4]) a higher risk of SCA was observed than in those with a low cardiovascular risk-profile (OR 1.3 [0.9-1.9]) The observed SCA risk was highest among OPD patients who received short-acting b2-adrenoreceptor agonists (SABA) or anticholinergics (AC) at the time of SCA (SABA OR: 3.9 [1.7-8.8], AC OR: 2.7 [1.5-4.8] compared to those without OPD). Conclusions: OPD is associated with an increased observed risk of SCA. The most increased risk was observed in patients with a high cardiovascular risk-profile, and in those who received SABA and, possibly, those who received AC at the time of SCA.
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页数:8
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