loading page

Montelukast Use Decreases Cardiovascular Events in Asthmatics
  • +6
  • Malvina Hoxha,
  • Calogero Tedesco,
  • Silvana Quaglini,
  • Visar Malaj,
  • Linda Pustina,
  • Valerie Capra,
  • Jilly Evans,
  • Angelo Sala,
  • G Enrico Rovati
Malvina Hoxha
Catholic University Our Lady of Good Counsel

Corresponding Author:malvis22@hotmail.com

Author Profile
Calogero Tedesco
Centro Cardiologico Monzino IRCCS
Author Profile
Silvana Quaglini
University of Pavia
Author Profile
Visar Malaj
University of Tirana
Author Profile
Linda Pustina
Ministry of Education and Sports
Author Profile
Valerie Capra
University of Milan
Author Profile
Jilly Evans
University of Pennsylvania
Author Profile
Angelo Sala
University of Milan
Author Profile
G Enrico Rovati
University of Milan
Author Profile

Abstract

Background: Cysteinyl leukotrienes are pro-inflammatory mediators with a clinically established role in asthma and a potential human genetic and preclinical role in cardiovascular diseases. Given that cardiovascular disease has a critical inflammatory component, the use of a leukotriene antagonist may represent an innovative therapy to target inflammation in cardiovascular prevention. Methods: We performed an observational retrospective (three years) study on eight hundred asthmatic patients 18 years or older in Albania, equally classified in two cohorts, exposed or non-exposed to montelukast, matched by age and gender. Patients with a previous history of myocardial infarction or ischemic stroke were excluded. Results: we considered eight hundred asthmatic patients (368 male and 432 female) 18 years or older. Overall 37 (4.6%) of the asthmatic patients, 32 non-exposed and 5 exposed, suffered a major cardiovascular event during the 3 years observation period. All the cardiovascular events occurred among patients with an increased cardiovascular risk. Thus, we used both a propensity score (PS) matching and a PS adjusted Cox model for analysis. In both analyses exposure to montelukast remained a significant protective factor for incident ischemic events (HR = 0.222; HR = 0.241, respectively), independently from gender. The event-free Kaplan-Meier survival curves confirmed the lower cardiovascular incidence of patients exposed to montelukast (p = <0.0001). Conclusion: Collectively, our data indicates that there is a potential protective role of montelukast for incident ischemic events in the older asthmatic population, suggesting a co-morbidity benefit of montelukast in asthmatics and possible innovative therapy to target inflammation for cardiovascular prevention.
13 Jan 2021Published in Frontiers in Pharmacology volume 11. 10.3389/fphar.2020.611561