ArticleInternational journal of chronic obstructive pulmonary disease2025
Risk of Hospitalized Cardiovascular Events Associated with LAMA/LABA/ICS FDC versus LABA/ICS FDC in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Cohort Study.
Article in International journal of chronic obstructive pulmonary disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
Background: Clinical trial data showed a potential, albeit conflicting, higher cardiovascular risk associated with an inhaled triple therapy of long-acting muscarinic antagonists, long-acting β2 agonists, and inhaled corticosteroids (LAMA/LABA/ICS) versus LABA/ICS in patients with chronic obstructive pulmonary disease (COPD). Evidence from routine care environments remains scant. We sought to assess cardiovascular safety profiles of LAMA/LABA/ICS versus LABA/ICS, targeting fixed-dose combination (FDC) single inhalers. Methods: This cohort study conducted in a nationwide Taiwanese database recruited patients with COPD who received LAMA/LABA/ICS FDC or LABA/ICS FDC between 2019/1/1 and 2022/12/31. We applied Cox regression models with variable-ratio propensity score (PS) matching to compare hospitalized cardiovascular events, including acute myocardial infarction, unstable angina, ischemic stroke, heart failure, and cardiac dysrhythmia, between the treatment groups. Results: A total of 28,851 patients (n=5,836 for LAMA/LABA/ICS FDC and n=23,015 for LABA/ICS FDC) were included in the PS-matched cohort. The hazard ratio (HR) of composite cardiovascular events comparing LAMA/LABA/ICS FDC to LABA/ICS FDC was 1.00 (95% confidence interval [CI], 0.78-1.28) and the results did not materially change for individual outcomes. There was also no increased risk associated with LAMA/LABA/ICS FDC in patients having prior hospitalized cardiovascular episodes (HR, 0.86; 95% CI, 0.62-1.20), having prior hospitalized COPD exacerbations (HR, 0.93; 95% CI, 0.62-1.39), or receiving treatment longer than one year (HR, 0.76; 95% CI, 0.38-1.54). Conclusion: This Taiwanese cohort study did not find a higher risk of various cardiovascular outcomes comparing LAMA/LABA/ICS FDC versus LABA/ICS FDC in patients with COPD, even in high-risk subpopulations.
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