{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:49:53Z","timestamp":1753890593805,"version":"3.41.2"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We investigated the effects of medication on heart disease and ischemic stroke (HDS) risk in patients with predominant bronchiectasis-asthma combination (BCAS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>BCAS and non-BCAS cohorts (<jats:italic>N<\/jats:italic> = 588 and 1,118, respectively) were retrospectively enrolled. The cumulative incidence of HDS was analyzed using Cox proportional regression; propensity scores were estimated using non-parsimonious multivariable logistic regression. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for HDS were calculated, adjusting for sex, age, comorbidities, and medication {long- and short-acting \u03b22 agonists and muscarinic antagonists (LABAs\/SABAs and LAMAs\/SAMAs), steroids [inhaled corticosteroid steroids (ICSs), oral steroids (OSs)], antiarrhythmics, antidepressants (fluoxetine), benzodiazepines (alprazolam, fludiazepam), statins and antihypertensive drugs (diuretics, cardioselective beta blockers, calcium channel blockers (CCBs) and angiotensin converting enzyme inhibitors (ACEi), angiotensin II blockers)}.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with the non-BCAS cohort, the BCAS cohort taking LABAs, SABAs, SAMAs, ICSs, OSs, antiarrhythmics, and alprazolam had an elevated HDS risk [aHRs (95% CIs): 2.36 (1.25\u20134.33), 2.65 (1.87\u20133.75), 2.66 (1.74\u20134.05), 2.53 (1.61\u20133.99), 1.76 (1.43\u20132.18), 9.88 (3.27\u201330.5), and 1.73 (1.15\u20132.58), respectively except fludiazepam 1.33 (0.73\u20132.40)]. The aHRs (95% CIs) for LABAs \u2264 30 days, DDDs &amp;lt;415, ICSs \u2264 30 days were 1.10 (0.38\u20133.15), 2.95 (0.22\u201338.8), 1.45 (0.76\u20132.77). The aHRs (95% CIs) for current and recent alprazolam were 1.78 (1.09\u20132.93) and 777.8 (1.34\u2013451590.0); for current and past fludiazepam were 1.39 (0.75\u20132.59) and 1.29 (0.42\u20134.01) and for past alprazolam was 1.57 (0.55\u20134.46); respectively. The aHRs (95% CIs) for alprazolam &amp;gt;30 DDDs, fludiazepam &amp;gt;20 DDDs, ICSs \u2266415 DDDs, and OSs DDDs \u226615 were 1.60 (0.78\u20133.29), 2.43 (0.90\u20136.55), 5.02 (1.76\u201314.3), and 2.28 (1.43\u20133.62), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The bronchodilators, steroids, and antiarrhythmics were associated with higher risk of HDS, even low dose use of steroids. However, the current use of LABAs\/ICSs were not associated with HDS. Benzodiazepines were relatively safe, except for current or recent alprazolam use. Notably, taking confounders into account is crucial in observational studies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.797623","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T07:01:40Z","timestamp":1645081300000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Relationships Between Bronchodilators, Steroids, Antiarrhythmic Drugs, Antidepressants, and Benzodiazepines and Heart Disease and Ischemic Stroke in Patients With Predominant Bronchiectasis and 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