Respiratory Illness, β-Agonists, and Risk of Idiopathic Dilated Cardiomyopathy

• Published in: American journal of epidemiology 1995-08, Vol.142 (4), p.395-403
• Main Authors: Coughlim, Steven S., Metayer, Catherine, McCarthy, Ellen P., Mather, Frances J., Waldhom, Richard E., Gersh, Bernard J., DuPraw, Stephen, Baughman, Kenneth L.
• Format: Article
• Language: English
• Subjects: asthma; bronchitis; cardiomyopathy; congestive; emphysema
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/oxfordjournals.aje.a117647

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.