Chronic-obstructive, pulmonary disease in heart failure. Prevalence, therapeutic and prognostic implications

• Type: Article in International Scientific Journal
• Date: 2008

Authors

Mascarenhas J (Author) FMUP; Lourenço P (Author) Other; Lopes R (Author) Other; Azevedo A (Author) FMUP; Bettencourt P (Author) FMUP

Journal

Title: American Heart Journal

Vol. 155

Pages: 521-525

ISSN: 0002-8703

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 80 Citations

Scopus - 94 Citations

Other information

Authenticus ID: P-004-0Z3

DOI: 10.1016/j.ahj.2007.10.040

Abstract (EN): Background Patients with heart failure (HF) frequently have comorbidities. Frequency, prognostic, and therapeutic implications of chronic obstructive pulmonary disease (COPD) in HF are largely unknown. We aimed to assess the prevalence and prognostic implications of COPD in a sample of stable patients with HF and to determine the frequency of beta-blocker (bB) use and rate of withdrawal according to COPD coexistence. Methods We conducted a retrospective cohort study including 186 patients followed in an outpatient HF clinic. All patients had left ventricular systolic dysfunction and a spirometry result. Patients were classified according to the GOLD guidelines. Treatment was instituted at the discretion of the attending physicians. Prognosis was compared between groups using Cox proportional hazards regression. The primary end point was death or all-cause hospitalization. Results The prevalence of COPD was 39.2% (73/186). No difference was detected between the COPD and non-COPD, groups in the rate of bB use (86.3% vs 87.6%, P = .97) and withdrawal (11.1% and 8.1%, P = .71). Mean follow-up was 14.2 +/- 8.8 months. The primary end point occurred in 71 (38.2%) patients-32 in the COPD group and 39 in the remaining (43.8% and 34.5%, respectively; hazard ratio 1.40, 95% CI 0.88-2.24). Severe COPD (GOLD stages III and IV) was associated with an adverse outcome (hazard ratio 2.10, 95% CI 1.05-4.22). Conclusions We observed a high COPID prevalence in stable patients with HF. Severe COPD predicted worse prognosis. Rates of bB use were high and rates of bB withdrawal were low; both were independent of COPD.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5