uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Effects of Cardiovascular Drugs on Mortality in Severe Chronic Obstructive Pulmonary Disease: A Time-Dependent Analysis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
2013 (English)In: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 187, no 7, 715-720 p.Article in journal (Refereed) Published
Abstract [en]

Rationale:

Cardiovascular drugs may improve survival in chronic obstructive pulmonary disease (COPD). However, previous studies did not account for major sources of bias, and drug effects have not been evaluated in severe COPD.

Objectives:

To estimate the time-dependent effects of cardiovascular drugs on survival in oxygen-dependent COPD, accounting for immortal and immeasurable time bias.

Methods:

Prospective national study of patients starting long-term oxygen therapy for COPD in Sweden between 1 October 2005 and 30 June 2009. Effects on mortality were estimated using extended Cox regression adjusted for age, sex, Pa-O2, Pa-CO2, World Health Organization performance status, body mass index, comorbidity, and concomitant medications. Immortal and immeasurable time bias was addressed by analyzing all medications as time-dependent variables and accounting for hospitalized time, respectively.

Measurements and Main Results:

Time-dependent effects of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, antiplatelet drugs, beta-blockers, and statins on all-cause mortality were measured. Of the 2,249 included patients, 1,129 (50%) died under observation. No patient was lost to follow-up. The adjusted time-dependent model was compatible with reduced mortality for antiplatelet drugs (hazard ratio [HR], 0.86; 95% CI, 0.75-0.99; P = 0.030) and trends for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (HR, 0.90; 95% CI, 0.79-1.04; P = 0.166) and statins (HR, 0.86; 95% CI, 0.72-1.03; P = 0.105), whereas beta-blockers increased mortality (HR, 1.19; 95% CI, 1.04-1.37; P = 0.010). Conclusions: This study supports that antiplatelet drugs improve survival

Place, publisher, year, edition, pages
2013. Vol. 187, no 7, 715-720 p.
Keyword [en]
chronic obstructive pulmonary disease, long-term oxygen therapy, survival, comorbidity
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:uu:diva-282859DOI: 10.1164/rccm.201208-1565OCPubMedID: 23328521OAI: oai:DiVA.org:uu-282859DiVA: diva2:917639
Available from: 2016-04-07 Created: 2016-04-07 Last updated: 2017-08-22Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Bornefalk Hermansson, Anna

Search in DiVA

By author/editor
Bornefalk Hermansson, Anna
By organisation
UCR-Uppsala Clinical Research Center
In the same journal
American Journal of Respiratory and Critical Care Medicine
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 181 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf