{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:32:20Z","timestamp":1785367940543,"version":"3.55.0"},"reference-count":55,"publisher":"European Respiratory Society (ERS)","issue":"180","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir Rev"],"accepted":{"date-parts":[[2026,1,20]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>COPD frequently coexists with cardiovascular diseases. Cardiovascular death is also a major contributor to mortality in COPD patients. Inhaled corticosteroids (ICS), as the most commonly prescribed inhaled anti-inflammatory medications, have been widely used for management of COPD patients who experience frequent exacerbations. However, whether ICS have a cardiovascular protective effect remains unclear. The purpose of this work was to comprehensively ascertain the risks of cardiovascular deaths related to ICS in COPD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, the Cochrane Library and Embase were searched to screen qualifying articles from September to November 2022. An updated search was conducted in October 2025. We identified trials of any ICS for treatment of COPD and reported on cardiovascular deaths. Meta-analyses were conducted to calculate risk ratios with 95% confidence intervals. The primary end-point was cardiovascular mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      35 randomised controlled trials enrolling 74\u2009004 subjects were analysed. Inhaled formulations containing ICS significantly reduced the risk of cardiovascular deaths compared with inhaled formulations without ICS (risk ratio 0.84, 95% CI 0.74\u20130.95). ICS\/long-acting muscarinic antagonist (LAMA)\/long-acting \u03b2\n                      <jats:sub>2<\/jats:sub>\n                      -agonist (LABA) significantly reduced the risk of cardiovascular deaths compared with dual LAMA\/LABA therapy (risk ratio 0.56, 95% CI 0.37\u20130.86). ICS monotherapy also significantly reduced the risk of cardiovascular deaths compared with placebo (risk ratio 0.81, 95% CI 0.66\u20130.99). However, ICS\/LABA did not significantly reduce the risk of cardiovascular deaths compared to LABA monotherapy (risk ratio 0.98, 95% CI 0.80\u20131.20).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Inhaled formulations containing ICS are associated with a reduced risk of cardiovascular deaths in patients with COPD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/16000617.0254-2025","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T08:30:17Z","timestamp":1775637017000},"page":"250254","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between inhaled corticosteroids and risk of cardiovascular mortality in patients with COPD: a systematic review and meta-analysis"],"prefix":"10.1183","volume":"35","author":[{"given":"Ming-Jin","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai-Yun","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-Mei","family":"Ying","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing-Xing","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Liang","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don D.","family":"Sin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"2026062507400786000_35.180.250254.1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00239-2023"},{"key":"2026062507400786000_35.180.250254.2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1613998"},{"key":"2026062507400786000_35.180.250254.3","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0057-2018"},{"key":"2026062507400786000_35.180.250254.4","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.rmed.2017.09.002","article-title":"Effect of budesonide\/formoterol pressurized metered-dose inhaler on exacerbations versus formoterol in chronic obstructive pulmonary disease: the 6-month, randomized RISE (Revealing the Impact of Symbicort in reducing Exacerbations in COPD) study","volume":"132","author":"Ferguson","year":"2017","journal-title":"Respir Med"},{"key":"2026062507400786000_35.180.250254.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2008.04.019"},{"key":"2026062507400786000_35.180.250254.6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200602-244OC"},{"key":"2026062507400786000_35.180.250254.7","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/j.rmed.2014.05.013","article-title":"Extrafine beclomethasone\/formoterol in severe COPD patients with history of exacerbations","volume":"108","author":"Wedzicha","year":"2014","journal-title":"Respir Med"},{"key":"2026062507400786000_35.180.250254.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713901"},{"key":"2026062507400786000_35.180.250254.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1916046"},{"key":"2026062507400786000_35.180.250254.10","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200404-543OC"},{"key":"2026062507400786000_35.180.250254.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"2026062507400786000_35.180.250254.12","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.033502"},{"key":"2026062507400786000_35.180.250254.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"2026062507400786000_35.180.250254.14","unstructured":"Global Initiative for Asthma . 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