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William B. White, MD on behalf of the coauthors
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From the Division of Hypertension and Clinical Pharmacology, Calhoun Cardiology Center, University of Connecticut School of Medicine.

Correspondence to: William B. White, MD, Division of Hypertension and Clinical Pharmacology, Calhoun Cardiology Center, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030-3940; e-mail: wwhite@nso1.uchc.edu


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr White has research funding from the National Institutes of Health unrelated to the content of this article. He is the president of the American Society of Hypertension, Inc for 2012 to 2014. Dr White is a consultant regarding the cardiovascular safety of numerous noncardiac drugs and devices (steering committees, data safety monitoring committees, and cardiovascular end point committees) for companies including Ardea Biosciences, Inc; AstraZeneca; Forest Research Institute, Inc; Eli Lilly and Company; Roche; Teva Pharmaceutical Industries, Ltd; and Takeda Global Research and Development Center, Inc.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(3):1082-1083. doi:10.1378/chest.13-1315
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To the Editor:

The intention of our study, reported in this issue of CHEST,1 was to evaluate the cardiovascular (CV) safety of roflumilast in > 12,000 patients with COPD using adjudicated major adverse CV events (MACEs) of CV death, nonfatal myocardial infarction, and nonfatal stroke. The results of our study showed that the hazard ratios for roflumilast relative to placebo were similar and in the same direction (< 1) for all three components of this MACE composite.1 Oba and Lone stated incorrectly that stroke was the only MACE component that was significantly different for roflumilast relative to placebo. In fact, none of the components met statistical significance for a reduction in CV events. We concluded that our large analysis demonstrated the lack of a CV safety concern for roflumilast in patients with moderate to severe COPD, and the results generated the hypothesis of potential benefit, particularly in those patients lacking CV comorbidities at baseline.1 The absolute and relative CV effects of roflumilast are currently being evaluated in purposefully designed, prospective randomized trials.

References

White WB, Cooke GE, Kowey PR, et al. Cardiovascular safety in patients receiving roflumilast for the treatment of COPD. Chest. 2013;144(3):758-765.
 

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References

White WB, Cooke GE, Kowey PR, et al. Cardiovascular safety in patients receiving roflumilast for the treatment of COPD. Chest. 2013;144(3):758-765.
 
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