Relationship of inhaled long-acting bronchodilators with cardiovascular outcomes among patients with stable COPD: a meta-analysis and systematic review of 43 randomized trials

Figures & data

Table 1 Subgroup of specific cardiovascular outcome

Type of ILAB	OCAE HR (95% CI), P	SCAE HR (95% CI), P	Arrhythmia HR (95% CI), P	Hypertension HR (95% CI), P	MI HR (95% CI), P	Cardiac Failure HR (95%CI), P	Stroke HR (95%CI), P	Cardiac ischemia HR (95%CI), P
Aclidinium	0.89 (0.38–2.08), 0.278	-	-	0.87 (0.44–1.71), 0.408	-	-	-	-
Acldinium/formoterol	0.7 8(0.41–1.48), 0.000	-	-	0.78 (0.41–1.48), 0.566	-	-	-	-
Formoterol	0.91 (0.67–1.25), 0.056	0.62 (0.30–1.29), 0.475	0.85 (0.60–1.19), 0.319	0.76 (0.50–1.14), 0.408	0.67 (0.22–1.99), 0.221	1.63 (0.50–5.33), 0.103	0.74 (0.12–4.72), 0.236	0.53 (0.32–0.91), 0.676
Glycopyrrolate	0.98 (0.63–1.53), 0.024	0.80 (0.31–2.06), 0.775	1.34 (0.46–3.98), 0.012.	0.68 (0.43–1.07), 0.391	0.49 (0.09–2.68), 0.432	0.96 (0.37–2.45), 0.555	1.99 (0.50–7.92), 0.997	0.56 (0.28–1.10), 0.685
Glycopyrrolate/ formoterol	1.19 (0.23–6.06), 0.005	0.82 (0.14–4.75), 0.845	-	-	-	1.37 (0.54–3.48), 0.314	-	-
Indacaterol	1.03 (0.72–1.47), 0.022	1.07 (0.71–1.60), 0.487	0.94 (0.62–1.43), 0.331	0.61 (0.29–1.28), 0.178	1.02 (0.60–1.72), 0.532	2.06 (0.87–4.88), 0.828	0.68(0.32–1.49), 0.630	-
Indacaterol/ glycopyrrolate	1.63 (0.85–3.15), 0.626	-	-	-	-	-	-	-
Olodaterol	0.65 (0.49–0.88), 0.238	-	1.22 (0.38–3.85), 0.096	0.66 (0.43–1.03), 0.309	-	-	-	-
Salmeterol	1.03 (0.89–1.18), 0.671	0.91 (0.76–1.08), 0.906	1.41 (0.71–2.79), 0.551		-	-	-	1.68 (0.65–4.37), 0.576
Tiotropium	1.01 (0.80–1.28), 0.006	0.92 (0.74–1.15), 0.825	0.73 (0.44–1.22), 0.194	0.83 (0.39–1.75), 0.194	0.81 (0.62–1.05), 0.378	0.90 (0.60–1.35), 0.897	1.04 (0.78–1.39), 0.905	1.13 (0.16–7.93), 0.011
Umeclidinium	1.28 (0.46–3.57), 0.000	0.67 (0.07–6.46), 43	-		-	-	-	-
Vilanterol	0.94 (0.74–1.19), 0.047	0.95 (0.78–1.16), 0.961	-	0.77 (0.06–9.88), 0.095	-	-	-	-
Umeclidinium/ vilanterol	1.12 (0.61–2.06)	0.68 (0.07–6.53)	-	-	-	-	-	-

Abbreviations: ILAB, inhaled long-acting bronchodilator; OCAE, overall cardiovascular adverse event; SCAE, severe fatal cardiovascular adverse event; MI,myocardial infarction.

Figure 1 The RRs of ILABs for the risk of OCAE in stable COPD.

Abbreviations: RR, relative risk; ILAB, inhaled long-acting bronchodilator; OCAE, overall cardiovascular adverse event; COPD, chronic obstructive pulmonary disease.

Figure 2 The RRs of ILABs for the risk of FCAE in stable COPD.Abbreviations: RR, relative risk; ILAB, inhaled long-acting bronchodilator; FCAE, fatal cardiovascular adverse event; COPD, chronic obstructive pulmonary disease.