Asthma may predict CVD events
CHICAGO — In two studies presented at the American Heart Association Scientific Sessions, patients with asthma had an increased risk for incident CVD events, including MI, compared with patients with no asthma.
Matthew C. Tattersall, DO, MS, and colleagues evaluated data from 6,792 participants of the MESA trial who had no evidence of CVD at baseline. The participants’ mean age was 62 years, 47% were men, 28.4% were white, 28% were black, 22% were Hispanic and 12% were Chinese American.
Matthew C. Tattersall*
The participants were followed for an average of 9.1 years for the development of CVD, including CV-related death, MI, angina and stroke. Tattersall and colleagues compared outcomes among 156 participants with chronic asthma treated with controller medications such as corticosteroids or leukotriene inhibitors, 511 participants with asthma who did not use medication and 6,125 participants without asthma.
The 10-year rate of freedom from CVD events was significantly lower for participants with asthma using medication compared with treatment-naive participants with asthma and participants with no asthma (84.1% vs. 91.1% vs. 90.2%, respectively; P=.028). After adjustment for confounders, asthmatic participants using medication continued to have a greater risk for CVD events compared with participants with no asthma (HR=1.59; 95% CI, 1.01-2.5). The researchers observed no significant difference after adjustment in the CVD event rate between asthmatic participants according to controller medication use.
Compared with the other groups, participants with asthma using medication also had significantly higher levels of inflammatory markers including C-reactive protein (1.2 mg/dL vs. 0.9 mg/dL treatment-naive asthmatics vs. 0.6 mg/dL no asthma; P<.006) and fibrinogen (379 mg/dL vs. 356 mg/dL vs. 345 mg/dL; P<.006) after adjustment for age.
“Asthmatics have a higher risk for CVD. What drives that risk is still uncertain. … Clinicians should be more cognizant of addressing modifiable risk factors in primary prevention patients with asthma,” Tattersall, assistant professor of medicine in the cardiology division at University of Wisconsin-Madison School of Medicine and Public Health, told Cardiology Today.
Young J. Juhn
In a separate presentation, Young J. Juhn, MD, MPH, and colleagues reported data from a population-based, retrospective, case-control study of 543 adults from Olmsted County, Minn., who developed MI between November 2002 and May 2006. The participants’ mean age was 67.5 years and 44% were women.
Fifteen percent of patients with MI had a history of asthma compared with 10% of age-, sex- and residency-matched control participants. This difference was not significant after adjustment for comorbid conditions, including chronic obstructive pulmonary disease (COPD; adjusted OR=1.36; 95% CI, 0.85-2.17). However, the researchers noted that removal of COPD from the multivariable model yielded a significant association between asthma and MI risk (adjusted OR=1.69; 95% CI, 1.07-2.67).
A subgroup analysis of 133 patients with asthma indicated a significant increased risk for MI among patients with active asthma compared inactive asthma (adjusted OR=2.3; 95% CI, 1.12-4.72). Active asthma was defined as the use of asthma medications and unscheduled medical visits related to asthma within 1 year of index MI.
“While inactive asthma did not increase the risk for MI, active asthma or poorly controlled asthma is associated with increased risk of MI,” Juhn, professor of pediatrics and adolescent medicine at Mayo Clinic, Rochester, Minn., told Cardiology Today. "Clinicians and patients with asthma should be aware of the risk for MI related to asthma status, and make an effort to better control asthma using therapeutic and preventive interventions." – by Adam Taliercio
For more information:
Bang DK. Abstract #16110.
Tattersall MC. Abstract #15991. Both presented at: American Heart Association Scientific Sessions 2014; Nov. 15-19, 2014; Chicago.
Disclosure: Juhn and Tattersall report no relevant financial disclosures.*Photo courtesy of Media Solutions/University of Wisconsin School of Medicine and Public Health