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Possible protection by inhaled budesonide against ischaemic cardiac events in mild COPD

¹ Dept of Respiratory Medicine and Allergology, Lund University, and, ⁵ AstraZeneca R&D, Lund, Sweden. ² Dept of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. ³ Dept of Thoracic Medicine, National Heart and Lung Institute, Imperial College, London, UK. ⁴ Dept of Respiratory Diseases, National Hospital Rikshospitalet, University of Oslo, Oslo, Norway.

CORRESPONDENCE: C-G. Löfdahl, Dept of Respiratory Medicine and Allergology, University Hospital, SE-22185 Lund, Sweden. Fax: 46 46146793. E-mail: claes-goran.lofdahl{at}med.lu.se

Keywords: Budesonide, chronic obstructive pulmonary disease, ischaemic cardiac events

Received: October 3, 2006
Accepted February 16, 2007

Epidemiological studies have indicated that chronic obstructive pulmonary disease (COPD) may be associated with an increased incidence of ischaemic cardiac events.

The current authors performed a post hoc analysis of the European Respiratory Society’s study on Chronic Obstructive Pulmonary Disease (EUROSCOP); a 3-yr, placebo-controlled study of an inhaled corticosteroid budesonide 800 µg·day^–1 in smokers (mean age 52 yrs) with mild COPD. The current study evaluates whether long-term budesonide treatment attenuates the incidence of ischaemic cardiac events, including angina pectoris, myocardial infarction, coronary artery disorder and myocardial ischaemia.

Among the 1,175 patients evaluated for safety, 49 (4.2%) patients experienced 60 ischaemic cardiac events. Patients treated with budesonide had a significantly lower incidence of ischaemic cardiac events (18 out of 593; 3.0%) than those receiving placebo (31 out of 582; 5.3%).

The results of the present study support the hypothesis that treatment with inhaled budesonide reduces ischaemic cardiac events in patients with mild chronic obstructive pulmonary disease.

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