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Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients
Due to frequent exacerbations, many patients with chronic obstructive pulmonary disease (COPD) are exposed to oral corticosteroids (OCS), which may be thrombogenic. We evaluated the risk of hospitalisation with venous thromboembolism (VTE) and death in patients with acute exacerbation of COPD (AECOP...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389624/ https://www.ncbi.nlm.nih.gov/pubmed/34440079 http://dx.doi.org/10.3390/biomedicines9080874 |
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author | Rastoder, Ema Sivapalan, Pradeesh Eklöf, Josefin Saeed, Mohamad Isam Jordan, Alexander Svorre Meteran, Howraman Tønnesen, Louise Biering-Sørensen, Tor Løkke, Anders Seersholm, Niels Lynghøj Nielsen, Thyge Carlsen, Jørn Janner, Julie Godtfredsen, Nina Bodtger, Uffe Laursen, Christian B. Hilberg, Ole Knop, Filip K. Priemé, Helene Ingebrigtsen, Truls Sylvan Gottlieb, Vibeke Wilcke, Jon Torgny Stæhr Jensen, Jens Ulrik |
author_facet | Rastoder, Ema Sivapalan, Pradeesh Eklöf, Josefin Saeed, Mohamad Isam Jordan, Alexander Svorre Meteran, Howraman Tønnesen, Louise Biering-Sørensen, Tor Løkke, Anders Seersholm, Niels Lynghøj Nielsen, Thyge Carlsen, Jørn Janner, Julie Godtfredsen, Nina Bodtger, Uffe Laursen, Christian B. Hilberg, Ole Knop, Filip K. Priemé, Helene Ingebrigtsen, Truls Sylvan Gottlieb, Vibeke Wilcke, Jon Torgny Stæhr Jensen, Jens Ulrik |
author_sort | Rastoder, Ema |
collection | PubMed |
description | Due to frequent exacerbations, many patients with chronic obstructive pulmonary disease (COPD) are exposed to oral corticosteroids (OCS), which may be thrombogenic. We evaluated the risk of hospitalisation with venous thromboembolism (VTE) and death in patients with acute exacerbation of COPD (AECOPD) treated with long and short OCS regimens. In this nationwide cohort study of 30,473 COPD outpatients treated for AECOPD, we compared the risk of VTE hospitalisation and all-cause mortality within 6 months in OCS dose of >250 mg vs. ≤250 mg. A multivariable Cox proportional hazard regression was used to estimate the risk. The incidence of VTE hospitalisations was 0.23%. A long OCS treatment course was associated with an increased risk of VTE compared to a short course (hazard ratio (HR) 1.69, [95% confidence interval (CI) 1.05 to 2.72], p < 0.031). A higher risk of all-cause mortality was seen in the group of COPD patients treated with a long OCS course (HR 1.71, [95% CI 1.63 to 1.79], p < 0.0001). The risk of reported VTE hospitalisation was higher among AECOPD patients treated with long courses of OCS, but the absolute risk was low, suggesting under-reporting of the condition. |
format | Online Article Text |
id | pubmed-8389624 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83896242021-08-27 Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients Rastoder, Ema Sivapalan, Pradeesh Eklöf, Josefin Saeed, Mohamad Isam Jordan, Alexander Svorre Meteran, Howraman Tønnesen, Louise Biering-Sørensen, Tor Løkke, Anders Seersholm, Niels Lynghøj Nielsen, Thyge Carlsen, Jørn Janner, Julie Godtfredsen, Nina Bodtger, Uffe Laursen, Christian B. Hilberg, Ole Knop, Filip K. Priemé, Helene Ingebrigtsen, Truls Sylvan Gottlieb, Vibeke Wilcke, Jon Torgny Stæhr Jensen, Jens Ulrik Biomedicines Article Due to frequent exacerbations, many patients with chronic obstructive pulmonary disease (COPD) are exposed to oral corticosteroids (OCS), which may be thrombogenic. We evaluated the risk of hospitalisation with venous thromboembolism (VTE) and death in patients with acute exacerbation of COPD (AECOPD) treated with long and short OCS regimens. In this nationwide cohort study of 30,473 COPD outpatients treated for AECOPD, we compared the risk of VTE hospitalisation and all-cause mortality within 6 months in OCS dose of >250 mg vs. ≤250 mg. A multivariable Cox proportional hazard regression was used to estimate the risk. The incidence of VTE hospitalisations was 0.23%. A long OCS treatment course was associated with an increased risk of VTE compared to a short course (hazard ratio (HR) 1.69, [95% confidence interval (CI) 1.05 to 2.72], p < 0.031). A higher risk of all-cause mortality was seen in the group of COPD patients treated with a long OCS course (HR 1.71, [95% CI 1.63 to 1.79], p < 0.0001). The risk of reported VTE hospitalisation was higher among AECOPD patients treated with long courses of OCS, but the absolute risk was low, suggesting under-reporting of the condition. MDPI 2021-07-23 /pmc/articles/PMC8389624/ /pubmed/34440079 http://dx.doi.org/10.3390/biomedicines9080874 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Rastoder, Ema Sivapalan, Pradeesh Eklöf, Josefin Saeed, Mohamad Isam Jordan, Alexander Svorre Meteran, Howraman Tønnesen, Louise Biering-Sørensen, Tor Løkke, Anders Seersholm, Niels Lynghøj Nielsen, Thyge Carlsen, Jørn Janner, Julie Godtfredsen, Nina Bodtger, Uffe Laursen, Christian B. Hilberg, Ole Knop, Filip K. Priemé, Helene Ingebrigtsen, Truls Sylvan Gottlieb, Vibeke Wilcke, Jon Torgny Stæhr Jensen, Jens Ulrik Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients |
title | Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients |
title_full | Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients |
title_fullStr | Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients |
title_full_unstemmed | Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients |
title_short | Systemic Corticosteroids and the Risk of Venous Thromboembolism in Patients with Severe COPD: A Nationwide Study of 30,473 Outpatients |
title_sort | systemic corticosteroids and the risk of venous thromboembolism in patients with severe copd: a nationwide study of 30,473 outpatients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8389624/ https://www.ncbi.nlm.nih.gov/pubmed/34440079 http://dx.doi.org/10.3390/biomedicines9080874 |
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