Leading COPD Drug May Raise Chances of Heart Trouble

Jan. 8 -- THURSDAY, Jan. 7 (HealthDay News) -- New research suggests that the drug ipratropium bromide (Atrovent), used widely among patients who have chronic obstructive pulmonary disease (COPD), may raise the risk of heart attack and heart failure, while a separate study of the COPD drug tiotropium (Spiriva) shows it may well lower the risk of heart problems and death.

The inhaled medications are the most commonly prescribed daily treatments for COPD, a respiratory illness that's the fourth-largest killer in the United States. The two studies are published in the January issue of Chest.

"The short-acting form [Atrovent] seems to increase cardiovascular risk, while the long-acting form [Spiriva] seems to decrease it," said Dr. Norman H. Edelman, chief medical officer of the American Lung Association. "It is important to point out, however, that the difference is an indirect inference," he added.

"To prove beyond scientific doubt that the two forms of anticholinergic drugs are different in this or other ways there would have to be a head-to-head comparison; a study which is not likely to be done," Edelman said.

In the first study, researchers led by Todd A. Lee, from the Hines VA Hospital in Illinois, collected data on 82,717 U.S. veterans with COPD. Among these patients, 44 percent were using Atrovent at some point during the study.

Those patients were followed until they had a cardiovascular event, died or until the study's end in September 2004. During the follow-up, 6,234 patients had a cardiovascular event: 44 percent suffered heart failure, 28 percent had heart attacks or chest pain, and 28 percent had irregular heart rhythms, the researchers reported.

Lee's team also found that during the first six months of Atrovent therapy, patients were at an increased risk for these cardiovascular events, although those who took the drug for more than six months without an incident did not have an increased risk of heart attack or heart failure.