Nursing

Patients who used inhaled anticholinergic agents for at least a month to treat their chronic obstructive pulmonary disease (COPD) showed a 58% increase in risk of cardiovascular death, myocardial infarction, or stroke, when compared with those who took a placebo or other inhaled agents, according to the results of a 17-trial meta-analysis published in the Sept. 24 issue of the Journal of the American Medical Association. The risk of CV death alone was 80% higher with the drugs studied, though overall numbers of CV deaths were low. The study authors, led by Dr. Sonal Singh of Wake Forest University, screened 17 randomized trials that ranged from six weeks to five years, involving 14,783 patients who took inhaled anticholinergic agents ipratropium bromide (Atrovent), ipratropium bromide combined with albuterol (Combivent), tiotropium bromide (Spiriva), or a control therapy, which could include placebo or inhaled beta agonists. Trials that included asthmatic patients were not part of the meta-analysis.

Heart Wire. "Inhaled anticholinergics for COPD raise CV-event risk in meta-analysis." 2008. http:// http://www.theheart.org/article/906953.do/ (23 Sept. 2008)