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| Title |
The association of renin–angiotensin system blockades and pneumonia requiring admission in patients with COPD
|
|---|---|
| Published in |
International Journal of Chronic Obstructive Pulmonary Disease, September 2016
|
| DOI | 10.2147/copd.s104097 |
| Pubmed ID | |
| Authors |
Junghyun Kim, Jung-Kyu Lee, Eun Young Heo, Hee Soon Chung, Deog Kyeom Kim |
| Abstract |
The hallmark of COPD is chronic airway inflammation, which may be mediated by renin-angiotensin system. The renin-angiotensin system blockers such as angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) have exhibited anti-inflammatory and immunomodulatory effects in patients with various diseases. We explored the effects of ACEi and ARBs on the risk of pneumonia in patients with COPD. A nested case-control study was performed on COPD patients recruited from January 2010 to August 2013 in two referral hospitals in Korea. A total of 130 COPD patients admitted with pneumonia were included, and 245 COPD patients without pneumonia were selected as controls from a total of 1,646 such patients. Controls were matched with test patients by age, sex, and severity of airflow limitation. The effects of ACEi/ARBs use on the odds ratio (OR) for the development of pneumonia were tested through conditional logistic regression. Elderly patients (over 70 years of age) constituted ~30% of each group; most of the patients were male (85%). Of the COPD patients with pneumonia, 21.5% had taken ACEi/ARBs for a mean of 9.8 months (standard deviation ±3.5 months). The proportions of ACEi/ARBs users and the mean duration of such use did not differ when compared to those of the control patients (26.9%, P=0.25; 9.6±3.6 months, P=0.83). Univariate analyses indicated that the use of ACEi/ARBs was not associated with a decreased risk of pneumonia (OR =0.70, 95% confidence interval 0.41-1.23, P=0.21), whereas both a history of pulmonary tuberculosis (OR =1.85, 95% confidence interval 1.12-3.06, P=0.02) and exposure to systemic steroids (OR =2.33, 95% confidence interval 1.28-4.23, P=0.005) did show an association. After adjustment for a history of tuberculosis, comorbid chronic renal disease, and exposure to corticosteroids, ACEi/ARBs reduced the risk of pneumonia in COPD patients (OR =0.51, 95% confidence interval 0.27-0.98, P=0.04). This study revealed that the use of ACEi/ARBs was associated with reducing the risk of pneumonia in patients with COPD. Further prospective studies are necessary to confirm the protective effect of ACEi/ARBs and elucidate the underlying mechanisms in COPD patients. |
X Demographics
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 50% |
| United Kingdom | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 31 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 31 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 5 | 16% |
| Other | 3 | 10% |
| Student > Ph. D. Student | 3 | 10% |
| Researcher | 3 | 10% |
| Student > Master | 3 | 10% |
| Other | 5 | 16% |
| Unknown | 9 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 35% |
| Unspecified | 2 | 6% |
| Nursing and Health Professions | 2 | 6% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 6% |
| Social Sciences | 2 | 6% |
| Other | 1 | 3% |
| Unknown | 11 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 September 2016.
All research outputs
#16,047,334
of 25,374,647 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#1,485
of 2,577 outputs
Outputs of similar age
#207,585
of 348,369 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#74
of 104 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. This one is in the 34th percentile – i.e., 34% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,577 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one is in the 37th percentile – i.e., 37% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 348,369 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 37th percentile – i.e., 37% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 104 others from the same source and published within six weeks on either side of this one. This one is in the 26th percentile – i.e., 26% of its contemporaries scored the same or lower than it.