ArticleBritish journal of clinical pharmacology2008
Use of beta2 agonists and risk of acute myocardial infarction in patients with hypertension.
Article in British journal of clinical pharmacology, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 33 citations in OpenAlex.
- Article
- A 10-year interval of cardiovascular effects of albuterol in asthma management: Graphical review.Current research in pharmacology and drug discovery · 2025Review
- Association between Inhaled βInternational journal of chronic obstructive pulmonary disease · 2022Article
- Stimulation of the Beta2 Adrenergic Receptor at Reperfusion Limits Myocardial Reperfusion Injury via an Interleukin-10-Dependent Anti-Inflammatory Pathway in the Spleen.Circulation journal : official journal of the Japanese Circulation Society · 2018Article
- A methodological comparison of two European primary care databases and replication in a US claims database: inhaled long-acting beta-2-agonists and the risk of acute myocardial infarction.European journal of clinical pharmacology · 2016Article
- Bridging differences in outcomes of pharmacoepidemiological studies: design and first results of the PROTECT project.Current clinical pharmacology · 2014Article
- Acute exacerbation of chronic obstructive pulmonary disease: cardiovascular links.BioMed research international · 2014Review
- Time-dependent propensity score and collider-stratification bias: an example of beta2-agonist use and the risk of coronary heart disease.European journal of epidemiology · 2013Article
- Predictors of incident atrial fibrillation and influence of medications: a retrospective case-control study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Article
- Concomitant use of ibuprofen and paracetamol and the risk of major clinical safety outcomes.British journal of clinical pharmacology · 2010Article
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
what is already known about this subject* Use of beta(2) agonists has been associated with tachycardia, an abnormal ECG and atrial fibrillation. * Previous observational studies of the association between use of beta(2) agonists and the risk of acute myocardial infarction (MI) have demonstrated conflicting results. * Instead of a causal effect, the positive association between beta(2) agonist use and MI may be explained by latent ischaemic heart disease, which has symptoms that appear similar to respiratory complaints in chronic obstructive pulmonary disease. WHAT THIS STUDY ADDS: * The majority of beta(2) agonist users in our study population did not have an increased risk of nonfatal acute MI. * Only patients with ischaemic heart disease and who had recently started beta(2) agonists had an increased risk of acute MI. * It is likely that this increased risk was related to latent cardiovascular disease rather than direct effects of beta(2) agonists.
aimObservational retrospective studies of the association between use of beta(2) agonists and the risk of acute myocardial infarction (MI) have demonstrated conflicting results, particularly among first-time users. The aim of this study was to examine the association between beta(2) agonist use and first nonfatal acute MI.
methodsWe conducted a case-control study (2476 cases) nested in a cohort of antihypertensive drug users in the Dutch PHARMO RLS database. PHARMO RLS consists of drug dispensing linked to the national hospitalizations register. Each case of nonfatal acute MI was matched with up to 12 control patients by gender, age and region. Drug and disease history and the severity of the underlying respiratory disease were adjusted for.
resultsRisk of acute MI was increased in current beta(2) agonist users [crude odds ratio (OR) 1.36, 95% confidence interval (CI) 1.15, 1.61]. However, this excess risk was reduced after adjustment for severity of asthma and chronic obstructive pulmonary disease (adjusted OR 1.18, 95% CI 0.93, 1.49). The risk was highest in patients with ischaemic heart disease and low cumulative dose of beta(2) agonists (adjusted OR 2.47, 95% CI 1.60, 3.82).
conclusionMost users of beta(2) agonists did not have an increased risk of acute MI. Only patients with ischaemic heart disease with low cumulative exposure to beta(2) agonists had an increased risk of acute MI. It is likely that this increased risk was related to latent cardiovascular disease rather than to the direct effects of beta(2) agonists.
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