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1 Division of Clinical Epidemiology, Royal Victoria Hospital, and Dept of Epidemiology and Biostatistics, McGill University, 3 Institut Cardiologique de Montréal, Université de Montréal, Montréal, Canada, 2 Laboratoire de Santé Publique EA 3279, Université de la Méditerranée, and Dépt d'Oncogénétique, Institut Paoli-Calmettes, Marseille, France
CORRESPONDENCE: S. Suissa, Division of Clinical Epidemiology, Royal Victoria Hospital, 687 Pine Avenue West, Ross 4.29, Montreal, Québec, Canada, H3A 1A1. Fax: 1 5148431493. E-mail: samy.suissa@clinepi.mcgill.ca
Keywords: Acute myocardial infarction, chronic obstructive pulmonary disease, cohort study, databases, inflammation, inhaled corticosteroids
Received: June 30, 2004
Accepted December 13, 2004
Inflammation plays a major role in the development and complications of atherosclerosis. Here, the dose-related impact of inhaled corticosteroids (ICS), used for their anti-inflammatory properties, on the risk of acute myocardial infarction (AMI) is studied in a cohort of chronic obstructive pulmonary disease (COPD) patients.
Saskatchewan (Canada) health services databases were used to form a population-based cohort of 5,648 patients,
ICS were used in the prior year by 42.2% of cases and 46.4% of controls. Overall, current use of ICS was not associated with a significant decrease in the risk of AMI. However, a 32% reduction in the risk of AMI was observed for doses ranging 50–200 µg·day–1.
In conclusion, very low doses of inhaled corticosteroids may be associated with a reduction in the risk of acute myocardial infarction.
55 yrs, who received a first treatment for COPD between 1990 and 1997. A nested case-control analysis was conducted, where 371 cases presenting with a first AMI were matched with 1,864 controls, based on the date of cohort entry and age. A conditional logistic regression was used to estimate the effect of ICS, after adjusting for use of oral corticosteroids, severity of COPD, sex, systemic hypertension, diabetes and cardiovascular disease.
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