Montelukast and the risk of major adverse cardiovascular events textendash a Danish population-based case-control study

Background: The leukotriene pathway has previously been associated with an increased risk of major adverse cardiologic events (MACE), and emerging evidence suggest that montelukast, a leukotriene receptor antagonist, might be associated with a decreased risk of MACE. The aim was to assess the potential association between montelukast use and the risk of MACE.Methods: We conducted a population-based case-control study based on Danish health register data. We included all adults who at some point during 2000-2016 lived on the island of Funen, and who (pop 490,000 in 2016) had a first-time occurrence of MACE (n=79,622). For each case, we age- and sex-matched up to 10 disease-free controls (n=793,549). Using conditional logistic regression, we estimated odds ratios (ORs) for MACE associated with cumulative use of montelukast.Results: In total, 900 cases (1.1 and 5,764 controls (0.7 had ever use of montelukast within the study period. A total of 20,727 (26 of the cases, and 61,657 (7.8 of the controls had a high burden of comorbidity (Charlson Comorbidity Index >=3). Ever use of montelukast was associated with a decreased risk of MACE when adjusting for comorbidity and education level (adjusted [adj]OR 0.79; 95% confidence interval [CI] 0.73-0.85), but no dose-response patterns were observed (cumulative use >=2000 defined daily doses: adjOR 0.65; 95%CI 0.47-0.88; long-term use >=10 years: adjOR 0.44; 95%CI 0.15-1.25). When further adjusting for respiratory- and antihypertensive treatment the decreased risk of MACE remained almost unchanged (adjOR 0.86; 95%CI 0.79-0.93]).Conclusion: We confirmed the previous reported decreased risk of MACE in patients treated with montelukast.FootnotesCite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA4475.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).