Abstract 15991: Chronic Asthma Predicts Cardiovascular Disease Events: The Multi-Ethnic Study of Atherosclerosis (MESA)
Background: Chronic asthma and cardiovascular disease (CVD) share a common inflammatory pathophysiology. We hypothesized that chronic asthma requiring daily controller medications is associated with higher CVD risk.
Methods: Presence of chronic asthma and use of controller medications (CM; inhaled corticosteroids, leukotriene inhibitors, oral corticosteroids) were assessed in the MESA at Exam 1. Participants were followed for a mean (standard deviation) 9.1 (2.8) years for development of CVD (coronary death, myocardial infarction, angina, stroke, and CVD death). Multivariable Cox regression models were used to assess associations of chronic asthma and CVD.
Results: The 6792 MESA participants were 62.2 (10.2) years old: 47% male, 28% African-American, 22% Hispanic and 2% Chinese. The 156 asthmatics that were on CM were compared with the 511 who were asthmatic but not on CM and the 6125 non-asthmatics. Asthmatics on CM, compared to those not on CM and non-asthmatics, respectively had higher age-adjusted levels of C-reactive protein (1.2 [1.2] vs 0.9 [1.2] vs 0.6 [1.2] mg/L) and fibrinogen (379  vs 356  vs 345  mg/dL) (both p<0.006). Asthmatics on CM had the lowest 10-year unadjusted CVD free survival rate of 84.1%, (95% confidence interval [CI] 78.9-90.3%) compared with asthmatics not on CM 91.1%, [95% CI 88.5-93.8%] and non-asthmatics 90.2%, [95% CI 89.4-91%] (p=0.028). After adjustment for age, sex, race, smoking, total and high-density lipoprotein cholesterol, systolic blood pressure, body-mass index, family history, income, anti-hypertensive and lipid medication use, asthmatics on CM had higher risk of CVD events than non-asthmatics (HR 1.6 [95% 1.01-2.5, p=0.040]). CVD-free survival was similar among asthmatics on or not on CM (p=0.155).
Discussion: In this large multi-ethnic cohort, asthmatics on CM had a higher CVD event rate compared to non-asthmatics. Increased CVD risk among asthmatics may be related to increased inflammatory stress.
Author Disclosures: M.C. Tattersall: None. M. Guo: None. C.E. Korcarz: None. A.D. Gepner: None. R. Barr: None. K.M. Donohue: None. R.L. McClelland: None. J.A. Delaney: None. J.H. Stein: None.
- © 2014 by American Heart Association, Inc.