Mucolytics, ICS/LABA combinations cut stroke risk among COPD patients with allied conditions

Patients with chronic obstructive pulmonary disease (COPD) and allied conditions are at heightened risk of stroke, but treatment with mucolytic agents and the combination of inhaled corticosteroids (ICS) plus long-acting β2-agonists (LABA) may protect against the risk, as shown in a study.

The study used data from the Longitudinal Health Insurance Database of Taiwan and included 24,173 patients diagnosed with COPD and allied conditions and 24,170 selected matched patients without COPD.

The median age of the entire population was 64 years, and 40.9 percent of participants were female. There were 1,003 (4.2 percent) patients in the COPD group and 391 (1.6 percent) in the control group who were admitted to hospital for stroke over a median observation time of 5.3 years and 5.5 years, respectively.

Multivariable Cox regression analysis showed that patients with newly-diagnosed COPD and allied conditions had a more than twofold risk of stroke compared with controls (adjusted hazard ratio [aHR], 2.72, 95 percent confidence interval [CI], 2.42–3.05; p<0.001).

In the COPD group, stroke risk was positively associated with old age (>65 years; aHR, 1.06), male sex (aHR, 1.39), hypertension (aHR, 1.46), diabetes mellitus (aHR, 1.33), and atrial fibrillation (aHR, 1.63). On the other hand, treatment with mucolytics (aHR, 0.44) and combination therapy with ICS/LABA (aHR, 0.75) exerted a risk-lowering effect.

The present data suggest that medications used for treating COPD and allied conditions may decrease stroke risk.