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(Chest. 2004;125:1174.)
© 2004 American College of Chest Physicians

Inhaled ß-Adrenoreceptor Agonists and Left Ventricular Systolic Function

Stephanie Noppe, MD; Adel Aminian, MD; Liliane Kayegeshe, MD; Roger Hallemans, MD and Bernard Hanson, MD

Hôpitaux Iris Sud Brussels, Belgium

Correspondence to: Bernard Hanson, MD, Hôpitaux Iris Sud (HIS), 142 Rue Marconi, Brussels B 1190, Belgium; e-mail: bernardhanson{at}swing.be

To the Editor:

We read with interest the article in CHEST by Au et al (June 2003)1 on the risk of inhaled ß-adrenoreceptor agonists in patients with left ventricular systolic dysfunction.

However, we were astonished not to see tobacco consumption among the recorded risk factors for death or degradation. Tobacco use remains the most preventable cause of death and disability in the United States.2

Far and away the most important cause of lung cancer is exposure to tobacco smoke through active or passive smoking.3 It also is a leading cause of COPD. Tobacco smoking also has been involved in terms of the rate of cardiac death.4 In 2000, Envangelista et al5 demonstrated, using a retrospective analysis of Veterans Affairs hospital records, that noncompliance with smoking restriction was a main risk factor for multiple hospital readmissions of patients with heart failure.

We would urge the authors of any study dealing with lung-related or heart-related morbidity or mortality to include tobacco usage as part of the variables assessed.

References

  1. Au, DH, Udris, EM, Fan, VS, et al (2003) Risk of mortality and heart failure exacerbations associated with inhaled ß-adrenoreceptor agonists among patients with known left ventricular systolic dysfunction. Chest 123,1964-1969[Abstract/Free Full Text]
  2. Batra, V, Patkar, A, Weibel, S, et al Public health implications of voters’ attitudes regarding statewide tobacco policy. Chest 2002;122,295-298[Abstract/Free Full Text]
  3. Alberg, AJ, Samet, JM Epidemiology of lung cancer. Chest 2003;123(suppl),21S-49S
  4. Fichtenberg, CM, Glantz, SA Association of the California tobacco control program with declines in cigarette consumption and mortality from heart disease, N Engl J Med 2000;343,1772-1777[Abstract/Free Full Text]
  5. Evangelista, LS, Doering, LV, Dracup, K Usefulness of a history of tobacco and alcohol use in predicting multiple heart failure readmissions among veterans. Am J Cardiol 2000;86,1339-1342[CrossRef][ISI][Medline]




This Article
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