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Cardiovascular and antacid treatment and mortality in oxygen‐dependent pulmonary fibrosis: A population‐based longitudinal study
Author(s) -
Ekström Magnus,
BornefalkHermansson Anna
Publication year - 2016
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12781
Subject(s) - medicine , antacid , proportional hazards model , idiopathic pulmonary fibrosis , population , hazard ratio , prospective cohort study , pulmonary fibrosis , comorbidity , diuretic , cardiology , gastroenterology , fibrosis , lung , confidence interval , environmental health
Background and objective Severe idiopathic pulmonary fibrosis is associated with an increased risk of cardiovascular disease and gastro‐oesophageal reflux, which may influence prognosis. We evaluated associations between cardiovascular and antacid medications, and mortality, in oxygen‐dependent pulmonary fibrosis (PF) of unknown cause. Methods Prospective population‐based study of adults starting long‐term oxygen therapy (LTOT) for PF in Sweden 2005–2009. PF of unknown cause was defined by excluding patients with known or probable secondary PF. Time‐dependent associations between medications and all‐cause mortality were analysed using extended Cox regression, adjusting for potential confounders including age, sex, vital capacity, blood gases, body mass index, performance status, comorbidity and concurrent medications. Results Of 462 included patients, 329 (71%) died under observation. No patient was lost to follow‐up. Angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB) were associated with reduced adjusted mortality (HR 0.63; 0.47–0.85) and antiplatelet drugs with increased mortality (HR 1.49; 1.11–2.00), largely driven by higher mortality in women. There were no associations with mortality for antacid treatments, β ‐blockers, diuretics or statins. Conclusion In oxygen‐dependent PF, treatment with ACEI/ARB was associated with improved survival, antiplatelet drugs with decreased survival, whereas there was no association between antacid, β ‐blocker, diuretic or statin treatment and survival.