Gianluca Testa1, Francesco Cacciatore2,3, Andrea Bianco4, David Della-Morte5,6, Francesca Mazzella2, Gianluigi Galizia7, Gaetano Gargiulo8, Francesco Curcio2, Ilaria Liguori2, Alexandra Sabusco9, Franco Rengo3, Domenico Bonaduce2, Pasquale Abete2. 1. Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, 86100,, Campobasso, Italy. gianluca.testa@unimol.it. 2. Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy. 3. IRCCS Salvatore Maugeri Foundation, Scientific Institute of Campoli/Telese, Benevento, Italy. 4. Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Naples, Italy. 5. Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy. 6. IRCCS San Raffaele Pisana, Rome, Italy. 7. IRCCS Salvatore Maugeri Foundation, Scientific Institute of Veruno, Novara, Italy. 8. Division of Geriatrics, AON SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. 9. Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, 86100,, Campobasso, Italy.
Abstract
BACKGROUND: Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are associated with high rates of mortality in elderly subjects. Concurrent CHF and COPD frequently occur, especially in with advancing age. This study examines long-term mortality in community-dwelling elderly subjects affected by CHF alone, COPD alone, and coexistent CHF and COPD. METHODS: The study evaluated 12-years mortality in 1288 subjects stratified for the presence or absence of CHF or COPD alone, and for coexistence of CHF and COPD. RESULTS: Mortality, at 12 year follow-up, was 46.7% overall, 68.6% in the presence of CHF alone (p < 0.001), 56.9% in the presence of COPD alone (p < 0.01); mortality was 86.2% where CHF and COPD coexisted (p < 0.001) and was significantly higher than in CHF or COPD alone (p < 0.05). Multivariate analysis indicates that CHF (Hazard risk = 1.67, 95% confidence interval 1.15-3.27, p < 0.031) and COPD (Hazard risk = 1.27, 95% confidence interval = 1.08-1.85, p < 0.042) were predictive of long-term mortality. When CHF and COPD simultaneously occurred, the risk dramatically increased up to 3.73 (95% confidence interval = 1.19-6.93, p < 0.001). CONCLUSIONS: Long-term follow-up showed higher mortality among elderly subjects affected by CHF or COPD. Simultaneous presence of CHF and COPD significantly increased the risk of death. Therefore, the presence of COPD in CHF patients should be considered a relevant factor in predicting high risk of mortality.
BACKGROUND:Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are associated with high rates of mortality in elderly subjects. Concurrent CHF and COPD frequently occur, especially in with advancing age. This study examines long-term mortality in community-dwelling elderly subjects affected by CHF alone, COPD alone, and coexistent CHF and COPD. METHODS: The study evaluated 12-years mortality in 1288 subjects stratified for the presence or absence of CHF or COPD alone, and for coexistence of CHF and COPD. RESULTS: Mortality, at 12 year follow-up, was 46.7% overall, 68.6% in the presence of CHF alone (p < 0.001), 56.9% in the presence of COPD alone (p < 0.01); mortality was 86.2% where CHF and COPD coexisted (p < 0.001) and was significantly higher than in CHF or COPD alone (p < 0.05). Multivariate analysis indicates that CHF (Hazard risk = 1.67, 95% confidence interval 1.15-3.27, p < 0.031) and COPD (Hazard risk = 1.27, 95% confidence interval = 1.08-1.85, p < 0.042) were predictive of long-term mortality. When CHF and COPD simultaneously occurred, the risk dramatically increased up to 3.73 (95% confidence interval = 1.19-6.93, p < 0.001). CONCLUSIONS: Long-term follow-up showed higher mortality among elderly subjects affected by CHF or COPD. Simultaneous presence of CHF and COPD significantly increased the risk of death. Therefore, the presence of COPD in CHFpatients should be considered a relevant factor in predicting high risk of mortality.
Authors: Cecilia Calabrese; Adriano Costigliola; Marianna Maffei; Vittorio Simeon; Francesco Perna; Eugenio Tremante; Elena Merola; Carlo Antonio Leone; Andrea Bianco Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-06-27
Authors: Seon Cheol Park; Dong Wook Kim; Eun Cheol Park; Cheung Soo Shin; Chin Kook Rhee; Young Ae Kang; Young Sam Kim Journal: Korean J Intern Med Date: 2019-10-16 Impact factor: 2.884