Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism.
OBJECTIVE
We conducted a cohort study to clarify this relationship between asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and pulmonary embolism (PE).


METHODS
From the National Health Insurance Research Database of Taiwan, we identified patients who had a diagnosis of asthma and a diagnosis of COPD (defined as ACOS) and concurrent treatment between January 1999 and December 2009 (ACOS cohort: n = 14,150; non-ACOS cohort: n = 55,876). Cox proportional hazards regression analysis was performed to determine the adjusted hazard ratios (aHRs) for PE of the ACOS cohort compared with the non-ACOS cohort.


RESULTS
Comparing the ACOS cohort with the non-ACOS cohort, the aHR of PE was 2.08 (95% confidence intervals [CIs]: 1.56-2.76). The risk of PE was higher in ACOS cohort than non-ACOS cohort, regardless of age, sex, comorbidity, inhaled corticosteroids (ICSs) and oral steroids (OSs) used. For ages ranging from 20 to 65 years, the aHR of PE was 2.53 (95% CI: 1.44-4.44) in the ACOS cohort. ACOS patients using ICSs (aHR: 1.97, 95% CI: 1.29-3.01) or OSs (aHR: 1.97, 95% CI: 1.46-2.65), the risk of PE was higher than in the non-ACOS cohort. The risk of PE increased with the number of outpatient visits and hospitalizations necessitated, ranging from 2.32 (95% CI: 1.54-3.52) in patients having 3-9 visits to 4.20 (95% CI: 2.74-6.44) for those having >9 visits.


CONCLUSIONS
ACOS is associated with increased risk of PE, particularly patients with a high frequency of AE-even in young adults or people without comorbidities.
Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.|Chia Nan University of Pharmacy and Science, Tainan, Taiwan.|Meiho University, Pingtung, Taiwan.
Jun-Jun
JJ
Yeh
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
Yu-Chiao
YC
Wang
Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.|Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
Chia-Hung
CH
Kao
D000328:Adult; D000368:Aged; D001249:Asthma / Q000378:metabolism / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000378:metabolism / Q000473:pathology*; D011655:Pulmonary Embolism / Q000378:metabolism / Q000473:pathology*; D012307:Risk Factors; D055815:Young Adult