Short-term outcomes in heart failure patients with chronic obstructive pulmonary disease in the community

• Published in: World journal of cardiology Vol. 4; no. 3; pp. 66 - 71
• Main Author: Noel O’Kelly William Robertson Jude Smith Jonathan Dexter Collette Carroll-Hawkins Sudip Ghosh
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 26.03.2012
• Subjects: Brief; Chronic; disease; failure; Heart; mortality; obstructive; pulmonary; Short-term; Heart failure; Chronic obstructive pulmonary disease; Short-term mortality
• ISSN: 1949-8462; 1949-8462
• DOI: 10.4330/wjc.v4.i3.66

AIM:To establish the short term outcomes of heart failure(HF)patients in the community who have concurrent chronic obstructive pulmonary disease(COPD).METHODS:We evaluated 783 patients(27.2%)with left ventricular systolic dysfunction under the care of a regional nurse-led community HF team between June 2007 and June 2010 through a database analysis.RESULTS:One hundred and one patients(12.9%)also had a diagnosis of COPD;94% of patients were treated with loop diuretics,83% with angiotensin converting enzyme inhibitors,74% with β-blockers;10.6% with bronchodilators;and 42% with aldosterone an-tagonists.The mean age of the patients was 77.9 ± 5.7 years;43% were female and mean New York Heart Association class was 2.3 ± 0.6.The mean follow-up was 28.2 ± 2.9 mo.β-blocker utilization was markedly lower in patients receiving bronchodilators compared with those not taking bronchodilators(overall 21.7% vs 81%,P < 0.001).The 24-mo survival was 93% in patients with HF alone and 89% in those with both comorbidities(P = not significant).The presence of COPD was associated with increased risk of HF hospitalization [hazard ratio(HR):1.56;95% CI:1.4-2.1;P < 0.001] and major adverse cardiovascular events(HR:1.23;95% CI:1.03-1.75;P < 0.001).CONCLUSION:COPD is a common comorbidity in ambulatory HF patients in the community and is a powerful predictor of worsening HF.It does not however appear to affect short-term mortality in ambulatory HF patients.