However, these data should not be easily dismissed. Systemic inflammation plays an important role in the pathogenesis of atherosclerosis and plaque rupture,5 and corticosteroids can cool the “fire” in the lungs and blood vessels of COPD patients.8,11 Moreover, there are a growing number of publications supporting the findings of the present study. Huiart and coworkers,16for instance, demonstrated a 32% reduction in the risk for acute myocardial infarction when low-dose inhaled corticosteroids were dispensed to COPD patients, compared with the risk among nonusers of corticosteroids. In a post hoc analysis of a large randomized controlled trial, the European Respiratory Society Study on Chronic Obstructive Pulmonary Disease trial17 investigators showed a 40% reduction in the cardiovascular event rate in patients who were assigned to receive inhaled budesonide compared with those assigned to receive placebo over a 3-year period. Most importantly, the Inhaled Steroid Effects Evaluation in COPD group has shown14 a 27% reduction in all-cause mortality in COPD patients who received inhaled corticosteroids compared with those who received placebo. Collectively, these data raise the tantalizing possibility that therapy with inhaled corticosteroids may be able to reduce mortality, and especially cardiovascular mortality, in COPD patients. Before incorporating this idea into clinical practice, however, more clinical and animal work is needed to better understand the mechanisms by which inhaled corticosteroids may reduce cardiovascular morbidity and mortality in COPD patients, and, more importantly, to identify novel therapeutic targets that can effectively reduce the growing health burden of COPD.