PMID- 26378450
OWN - NLM
STAT- MEDLINE
DCOM- 20160523
LR  - 20220408
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 10
IP  - 9
DP  - 2015
TI  - Inhaled Long-Acting beta2-Agonists Do Not Increase Fatal Cardiovascular Adverse 
      Events in COPD: A Meta-Analysis.
PG  - e0137904
LID - 10.1371/journal.pone.0137904 [doi]
LID - e0137904
AB  - BACKGROUND: The cardiovascular safety of inhaled long-acting beta2-agonists (LABAs) 
      in patients with chronic obstructive pulmonary disease (COPD) is a controversial 
      problem. Certain studies have suggested that inhaled LABAs lead to an increased 
      risk of cardiovascular events in patients with COPD. This meta-analysis aimed to 
      assess the cardiovascular safety of inhaled LABAs in COPD. METHODS: A 
      meta-analysis of randomized, double-blind, parallel-group, placebo-controlled 
      trials for LABA treatment of COPD with at least 3 months of follow-up was 
      performed. The fixed-effects model was used to evaluate the effects of LABAs on 
      fatal cardiovascular adverse events. Adverse events were collected for each 
      trial, and the relative risk (RR) and 95% confidence intervals (CI) for 
      LABA/placebo were estimated. RESULTS: There were 24 trials included in this 
      meta-analysis. Compared with placebo, inhaled LABAs significantly decreased fatal 
      cardiovascular adverse events in COPD patients (RR 0.65, 95% CI 0.50 to 0.86, P = 
      0.002). In sensitivity analysis, there was still no increased risk of fatal 
      cardiovascular events (RR 0.68, 95%CI 0.46 to 1.01, P = 0.06) after excluding the 
      trial with the largest weight. Among the different types of LABAs, only 
      salmeterol had a significant effect (RR 0.64, 95% CI 0.46 to 0.90). In subgroup 
      analyses, inhaled LABAs were able to significantly decrease fatal cardiovascular 
      events in long-term trials (RR 0.64, 95% CI 0.47 to 0.87) and in trials with 
      severe COPD patients (RR 0.69, 95% CI 0.50 to 0.96). CONCLUSION: Inhaled LABAs do 
      not increase the risk of fatal cardiovascular events in COPD patients.
FAU - Xia, Ning
AU  - Xia N
AD  - Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, 
      Beijing, China.
FAU - Wang, Hao
AU  - Wang H
AD  - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular 
      Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 
      Beijing, China.
FAU - Nie, Xiuhong
AU  - Nie X
AD  - Department of Respiratory Diseases, Xuanwu Hospital, Capital Medical University, 
      Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20150917
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Adrenergic beta-2 Receptor Agonists)
RN  - 0 (Bronchodilator Agents)
RN  - 6EW8Q962A5 (Salmeterol Xinafoate)
SB  - IM
MH  - Administration, Inhalation
MH  - Adrenergic beta-2 Receptor Agonists/*administration & dosage/*adverse effects
MH  - Bronchodilator Agents/administration & dosage
MH  - Cardiovascular Diseases/*chemically induced
MH  - Double-Blind Method
MH  - Humans
MH  - Middle Aged
MH  - Pulmonary Disease, Chronic Obstructive/*drug therapy
MH  - Randomized Controlled Trials as Topic
MH  - Salmeterol Xinafoate/administration & dosage/adverse effects
PMC - PMC4574772
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2015/09/18 06:00
MHDA- 2016/05/24 06:00
PMCR- 2015/09/17
CRDT- 2015/09/18 06:00
PHST- 2015/04/06 00:00 [received]
PHST- 2015/08/22 00:00 [accepted]
PHST- 2015/09/18 06:00 [entrez]
PHST- 2015/09/18 06:00 [pubmed]
PHST- 2016/05/24 06:00 [medline]
PHST- 2015/09/17 00:00 [pmc-release]
AID - PONE-D-15-11644 [pii]
AID - 10.1371/journal.pone.0137904 [doi]
PST - epublish
SO  - PLoS One. 2015 Sep 17;10(9):e0137904. doi: 10.1371/journal.pone.0137904. 
      eCollection 2015.