The Risk of Myocardial Infarction Associated with Inhaled β -Adrenoceptor Agonists

Beta-adrenoceptor agonists ( β -agonists), in widespread clinical use for obstructive lung disease, have been associated with an increased risk of cardiovascular mortality. The objective of this study was to assess the association between incident myocardial infarction and the use of inhaled β -agonists. We performed a case-control study within the Group Health Cooperative of Puget Sound (GHC). Between 1989 and 1994, we identified 1,444 cases with an incident myocardial infarction and 4,094 control subjects frequency-matched on age, sex, hypertension, and index date. The computerized pharmacy database of the health maintenance organization (HMO) was used to assess the use of β -agonists by metered dose inhaler (MDI). Cardiovascular risk factor information was obtained from medical record review. In comparison to subjects who did not fill a β -agonist prescription, subjects who had filled one β -agonist MDI prescription in the 3 mo prior to their index date had an elevated estimated risk of myocardial infa...

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