Inhaled Pharmacotherapy and Stroke Risk in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Population Based Study Using Two-Stage Approach
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{"title"=>"Inhaled Pharmacotherapy and Stroke Risk in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Population Based Study Using Two-Stage Approach", "type"=>"journal", "authors"=>[{"first_name"=>"Hui-Wen", "last_name"=>"Lin"}, {"first_name"=>"Chi-Li", "last_name"=>"Chung"}, {"first_name"=>"You Shuei", "last_name"=>"Lin"}, {"first_name"=>"Chia-Ming", "last_name"=>"Yu"}, {"first_name"=>"Chun-Nin", "last_name"=>"Lee"}, {"first_name"=>"Mauo-Ying", "last_name"=>"Bien"}], "year"=>2015, "source"=>"PLOS ONE", "identifiers"=>{"issn"=>"1932-6203", "pmid"=>"26158649", "doi"=>"10.1371/journal.pone.0130102"}, "id"=>"d01e6b9a-5536-30ee-b5b7-fbf79fcc89e6", "abstract"=>"BACKGROUND AND PURPOSE: Patients with chronic obstructive pulmonary disease (COPD) are at higher risk of stroke than those without COPD. This study aims to explore the impact of inhaled pharmacotherapy on stroke risk in COPD patients during a three-year follow-up, using a nationwide, population-based study and a matched cohort design.\\n\\nMETHODS: The study cohort comprised 10,413 patients who had received COPD treatment between 2004 and 2006; 41,652 randomly selected subjects comprised the comparison cohort. Cox proportional hazard regressions and two-stage propensity score calibration were performed to determine the impact of various inhaled therapies including short-acting muscarinic antagonists, long-acting muscarinic antagonists, short-acting β-agonists (SABAs), long-acting β-agonists (LABAs), and LABA plus inhaled corticosteroid (ICS), on the risk after adjustment for patient demographic characteristics and comorbid disorders.\\n\\nRESULTS: Of the 52,065 sampled patients, 2,689 (5.2%) developed stroke during follow-up, including 727 (7.0%) from the COPD cohort and 1,962 (4.7%) from the comparison cohort (p < 0.001). Treatment with SABA was associated with 1.67-fold (95% CI 1.45-1.91; p < 0.001) increased risk of stroke in COPD patients. By contrast, the cumulative incidence of stroke was significantly lower in those treated with LABA plus ICS than those treated without (adjusted hazard ratio 0.75, 95% CI 0.60-0.94, p = 0.014).\\n\\nCONCLUSIONS: Among COPD patients, the use of inhaled SABA is associated with an increased risk of stroke, and combination treatment with inhaled LABA and ICS relates to a risk reduction. Further prospective research is needed to verify whether LABA plus ICS confers protection against stroke in patients with COPD.", "link"=>"http://www.mendeley.com/research/inhaled-pharmacotherapy-stroke-risk-patients-chronic-obstructive-pulmonary-disease-nationwide-popula-2", "reader_count"=>9, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Librarian"=>1, "Student > Doctoral Student"=>2, "Researcher"=>1, "Student > Postgraduate"=>1, "Student > Master"=>1, "Student > Bachelor"=>1, "Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Librarian"=>1, "Student > Doctoral Student"=>2, "Researcher"=>1, "Student > Postgraduate"=>1, "Student > Master"=>1, "Student > Bachelor"=>1, "Lecturer"=>1}, "reader_count_by_subject_area"=>{"Engineering"=>1, "Unspecified"=>1, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>4, "Agricultural and Biological Sciences"=>1, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>4}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>1}}, "group_count"=>0}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2168986"], "description"=>"<p><i>Abbreviation</i>: COPD = chronic obstructive pulmonary disease; HR = hazard ratio; CI = confidence interval.</p><p><sup>a</sup>Adjustment for patient’s age, gender, hypertension, coronary heart disease, hyperlipidemia and diabetes.</p><p><sup>b</sup>Adjustment for patient’s age, gender, hypertension, coronary heart disease, hyperlipidemia and diabetes and unmeasured confounders including smoking, drinking and body mass index.</p><p>*<i>p</i> < 0.001.</p><p>The Crude and Adjusted Hazard Ratios for Stroke among the Sample Subjects during the Three-year Follow-up Period Starting from the Index Ambulatory Care Visits (N = 52,065).</p>", "links"=>[], "tags"=>["Chronic Obstructive Pulmonary Disease", "saba", "LABA", "inhaled", "cohort design.MethodsThe study cohort", "COPD patients", "ci", "stroke", "ics", "comparison cohort"], "article_id"=>1478200, "categories"=>["Biological Sciences"], "users"=>["Hui-Wen Lin", "Chi-Li Chung", "You Shuei Lin", "Chia-Ming Yu", "Chun-Nin Lee", "Mauo-Ying Bien"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0130102.t002", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_Crude_and_Adjusted_Hazard_Ratios_for_Stroke_among_the_Sample_Subjects_during_the_Three_year_Follow_up_Period_Starting_from_the_Index_Ambulatory_Care_Visits_N_52_065_/1478200", "title"=>"The Crude and Adjusted Hazard Ratios for Stroke among the Sample Subjects during the Three-year Follow-up Period Starting from the Index Ambulatory Care Visits (N = 52,065).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-09 02:52:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/2168987"], "description"=>"<p><i>Abbreviation</i>: COPD = chronic obstructive pulmonary disease; SAMA = shorting-acting muscarinic antagonist; SABA = short-acting β-agonists; LAMA = long-acting muscarinic antagonist; LABA = long-acting β-agonists; ICS = inhaled corticosteroid; HR = hazard ratio.</p><p><sup>a</sup>A brief use of SABA or SAMA on demand for acute exacerbation is allowed.</p><p><sup>b</sup>Adjustments for patient’s age, gender, hypertension, hyperlipidemia, coronary heart disease and diabetes.</p><p>Adjusted Hazard Ratios for Stroke (Included Ischemic Stroke and Hemorrhagic Stroke) between COPD Patients with or without Using the Five Categories of Inhaled Pharmacotherapy during Three-Year Follow-up (N = 10,413).</p>", "links"=>[], "tags"=>["Chronic Obstructive Pulmonary Disease", "saba", "LABA", "inhaled", "cohort design.MethodsThe study cohort", "COPD patients", "ci", "stroke", "ics", "comparison cohort"], "article_id"=>1478201, "categories"=>["Biological Sciences"], "users"=>["Hui-Wen Lin", "Chi-Li Chung", "You Shuei Lin", "Chia-Ming Yu", "Chun-Nin Lee", "Mauo-Ying Bien"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0130102.t003", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Adjusted_Hazard_Ratios_for_Stroke_Included_Ischemic_Stroke_and_Hemorrhagic_Stroke_between_COPD_Patients_with_or_without_Using_the_Five_Categories_of_Inhaled_Pharmacotherapy_during_Three_Year_Follow_up_N_10_413_/1478201", "title"=>"Adjusted Hazard Ratios for Stroke (Included Ischemic Stroke and Hemorrhagic Stroke) between COPD Patients with or without Using the Five Categories of Inhaled Pharmacotherapy during Three-Year Follow-up (N = 10,413).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-09 02:52:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/2168988"], "description"=>"<p><i>Abbreviation</i>: COPD = chronic obstructive pulmonary disease; SAMA = shorting-acting muscarinic antagonist; SABA = short-acting β-agonists; LAMA = long-acting muscarinic antagonist; LABA = long-acting β-agonists; ICS = inhaled corticosteroid; HR = hazard ratio.</p><p><sup>a</sup>A brief use of SABA or SAMA on demand for acute exacerbation is allowed.</p><p><sup>b</sup>Adjustment for patient’s age, gender, hypertension, coronary heart disease, hyperlipidemia and diabetes and unmeasured confounders including smoking, drinking and body mass index.</p><p>Adjusted Hazard Ratios for Stroke between COPD Patients with or without Using the Inhaled Pharmacotherapy by Propensity Score Calibration Method.</p>", "links"=>[], "tags"=>["Chronic Obstructive Pulmonary Disease", "saba", "LABA", "inhaled", "cohort design.MethodsThe study cohort", "COPD patients", "ci", "stroke", "ics", "comparison cohort"], "article_id"=>1478202, "categories"=>["Biological Sciences"], "users"=>["Hui-Wen Lin", "Chi-Li Chung", "You Shuei Lin", "Chia-Ming Yu", "Chun-Nin Lee", "Mauo-Ying Bien"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0130102.t004", "stats"=>{"downloads"=>9, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Adjusted_Hazard_Ratios_for_Stroke_between_COPD_Patients_with_or_without_Using_the_Inhaled_Pharmacotherapy_by_Propensity_Score_Calibration_Method_/1478202", "title"=>"Adjusted Hazard Ratios for Stroke between COPD Patients with or without Using the Inhaled Pharmacotherapy by Propensity Score Calibration Method.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-07-09 02:52:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/2168984"], "description"=>"<p>COPD = chronic obstructive pulmonary disease; SABA = short-acting β-agonist.</p>", "links"=>[], "tags"=>["Chronic Obstructive Pulmonary Disease", "saba", "LABA", "inhaled", "cohort design.MethodsThe study cohort", "COPD patients", "ci", "stroke", "ics", "comparison cohort"], "article_id"=>1478198, "categories"=>["Biological Sciences"], "users"=>["Hui-Wen Lin", "Chi-Li Chung", "You Shuei Lin", "Chia-Ming Yu", "Chun-Nin Lee", "Mauo-Ying Bien"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0130102.g001", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cumulative_incidence_of_stroke_in_COPD_patients_treated_with_and_without_inhaled_SABA_/1478198", "title"=>"Cumulative incidence of stroke in COPD patients treated with and without inhaled SABA.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-09 02:52:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/2168985"], "description"=>"<p>COPD = chronic obstructive pulmonary disease; LABA = long-acting β-agonist; ICS = inhaled corticosteroid.</p>", "links"=>[], "tags"=>["Chronic Obstructive Pulmonary Disease", "saba", "LABA", "inhaled", "cohort design.MethodsThe study cohort", "COPD patients", "ci", "stroke", "ics", "comparison cohort"], "article_id"=>1478199, "categories"=>["Biological Sciences"], "users"=>["Hui-Wen Lin", "Chi-Li Chung", "You Shuei Lin", "Chia-Ming Yu", "Chun-Nin Lee", "Mauo-Ying Bien"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0130102.g002", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Cumulative_incidence_of_stroke_in_COPD_patients_treated_with_and_without_inhaled_LABA_plus_ICS_/1478199", "title"=>"Cumulative incidence of stroke in COPD patients treated with and without inhaled LABA plus ICS.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-07-09 02:52:44"}

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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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