Inhaled anticholinergics and risk of major adverse cardiovascular events in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.

@article{Singh2008InhaledAA,
  title={Inhaled anticholinergics and risk of major adverse cardiovascular events in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.},
  author={Sonal Singh and Yoon Kong Loke and Curt D. Furberg},
  journal={JAMA},
  year={2008},
  volume={300 12},
  pages={
          1439-50
        }
}
CONTEXT Inhaled anticholinergics (ipratropium bromide or tiotropium bromide) are widely used in patients with chronic obstructive pulmonary disease (COPD) but their effect on the risk of cardiovascular outcomes is unknown. OBJECTIVE To ascertain the cardiovascular risks of inhaled anticholinergics, including cardiovascular death, myocardial infarction (MI), and stroke. DATA SOURCES Systematic searches were conducted on March 19, 2008, of relevant articles in MEDLINE, the Cochrane Database… Expand
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TLDR
Compared with control (placebo or salmeterol), tiotropium did not significantly increase the risk of adverse major cardiovascular events among COPD patients, and subgroup analysis suggested that smoking history can modify therisk of cardiovascular adverse events. Expand
Risk of major adverse cardiovascular events with inhaled anticholinergics in patients with chronic obstructive pulmonary disease.
TLDR
A 4-year randomized controlled trial involving 5993 patients showed no evidence of an increased risk of cardiovascular adverse events with the use of tiotropium, and the author is concerned that there may be errors in data entry and study inclusion in the meta-analysis. Expand
Risk of major adverse cardiovascular events with inhaled anticholinergics in patients with chronic obstructive pulmonary disease.
TLDR
A 4-year randomized controlled trial involving 5993 patients showed no evidence of an increased risk of cardiovascular adverse events with the use of tiotropium, and the author is concerned that there may be errors in data entry and study inclusion in the meta-analysis. Expand
Risk of major adverse cardiovascular events with inhaled anticholinergics in patients with chronic obstructive pulmonary disease.
TLDR
A 4-year randomized controlled trial involving 5993 patients showed no evidence of an increased risk of cardiovascular adverse events with the use of tiotropium, and the author is concerned that there may be errors in data entry and study inclusion in the meta-analysis. Expand
A systematic review of the cardiovascular risk of inhaled anticholinergics in patients with COPD
TLDR
A wide disparity in findings exists among the published studies evaluating the CV risks of inhaled anticholinergic agents, and Prospective, adequately powered RCTs are needed to provide more evidence for the CV safety of tiotropium. Expand
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TLDR
The preponderance of evidence suggests the possibility of a causal relationship between inhaled anticholinergics and urinary retention among patients with chronic obstructive pulmonary disease. Expand
Long-acting Inhaled Bronchodilator and Risk of Vascular Events in Patients With Chronic Obstructive Pulmonary Disease in Taiwan Population
TLDR
Treating patients with COPD, with a combination of LAAC and LABA, may be associated with an increased hazard of stroke compared with treatment with either agent alone, according to a large health insurance database. Expand
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TLDR
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Do Inhaled Anticholinergics Increase or Decrease the Risk of Major Cardiovascular Events?
TLDR
In conclusion, inhaled anticholinergics, especially tiotropium bromide, reduce COPD-related hospitalizations and deaths, and may improve total survival over time and it is possible that the reduction in respiratory morbidity could improve functional status and reduce adverse cardiac outcomes over time. Expand
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TLDR
Inhaled tiotropium does not increase the risk of cardiovascular events and cardiovascular mortality in patients with COPD, and there was also no association between cardiovascular risk and duration of tiotopium treatment. Expand
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