Respiratory illness, β-agonists, and risk of idiopathic dilated cardiomyopathy: The washington, dc, dilated cardiomyopathy study

Steven S. Coughlim, Catherine Metayer, Ellen P. Mccarthy, Frances J. Mather, Richard E. Waldhom, Bernard J. Gersh, Stephen Dupraw, Kenneth L. Baughman

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Abstract

An epidemiologic study was earned out to examine the possible role of β-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 β-agonists (adjusted OR= 3.4, 95% Cl 1.1-11.0) and β-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 β-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 β-agonist inhalers or oral preparations and clinical diagnosis of idiopathic dilated cardiomyopathy was taken into account, however, and the associations with duration of β-agonist medication use were not statistically significant (p > 0.05). The results of this study suggest, but do not prove, that use of β-agonists has an etiologic role in idiopathic dilated cardiomyopathy.

Original languageEnglish (US)
Pages (from-to)395-403
Number of pages9
JournalAmerican journal of epidemiology
Volume142
Issue number4
DOIs
StatePublished - Aug 15 1995

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Keywords

  • Asthma
  • Bronchitis
  • Cardiomyopathy
  • Congestive
  • Emphysema

ASJC Scopus subject areas

  • Epidemiology

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