RESPIRATORY ILLNESS, BETA-AGONISTS, AND RISK OF IDIOPATHIC DILATED CARDIOMYOPATHY - THE WASHINGTON, DC, DILATED CARDIOMYOPATHY STUDY

被引:43
作者
COUGHLIN, SS
METAYER, C
MCCARTHY, EP
MATHER, FJ
WALDHORN, RE
GERSH, BJ
DUPRAW, S
BAUGHMAN, KL
机构
[1] GEORGETOWN UNIV,SCH MED,DEPT MED,DIV PULM & CRIT CARE MED,WASHINGTON,DC
[2] GEORGETOWN UNIV,MED CTR,LOMBARDI CANC RES CTR,DIV MED ONCOL,WASHINGTON,DC 20007
[3] JOHNS HOPKINS UNIV,SCH MED,DEPT MED,DIV CARDIOL,BALTIMORE,MD 21205
关键词
ASTHMA; BRONCHITIS; CARDIOMYOPATHY; CONGESTIVE; EMPHYSEMA;
D O I
10.1093/oxfordjournals.aje.a117647
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
An epidemiologic study was carried out to examine the possible role of beta-agonists and other respiratory medications in the development of idiopathic dilated cardiomyopathy. Associations with respiratory medications, bronchial asthma, emphysema, and chronic bronchitis were examined by comparing newly diagnosed cases (n = 129) ascertained from five Washington, DC, area hospitals for the period 1990-1992 with neighborhood controls (n = 258) identified by using a random digit dialing technique, The cases and controls were matched on sex and 5-year age intervals and were compared in the analysis using conditional logistic regression methods. A statistically significant association was observed between idiopathic dilated cardiomyopathy and history of emphysema or chronic bronchitis (adjusted odds ratio (OR) = 4.4, 95% confidence interval (Cl) 1.6-12.4). The association with bronchial asthma was of borderline significance (adjusted OR = 1.9, 95% Cl 0.9-4.2), Associations were also observed with use of oral beta-agonists (adjusted OR = 3.4, 95% Cl 1.1-11.0) and beta-agonist inhalers or nebulization (adjusted OR = 3.2, 95% Cl 1.4-7.1), as well as with use of oral corticosteroids, inhaled corticosteroids or cromolyn, and theophylline medications, A total of 20.0% (23 of 115) of the cases had a reported history of beta-agonist inhaler use compared with 6.7% (17 of 254) of the controls, The strength of these associations was diminished when the temporal relation between exposure to beta-agonist inhalers or oral preparations and clinical diagnosis of idiopathic dilated cardiomyopathy was taken into account, however, and the associations with duration of beta-agonist medication use were not statistically significant (p > 0.05). The results of this study suggest, but do not prove, that use of beta-agonists has an etiologic role in idiopathic dilated cardiomyopathy.
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页码:395 / 403
页数:9
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