Marco Canepa1, Ewa Straburzynska-Migaj2, Jaroslaw Drozdz3, Carla Fernandez-Vivancos4, Jose Manuel Garcia Pinilla5, Noemi Nyolczas6, Pier Luigi Temporelli7, Alexandre Mebazaa8, Mitja Lainscak9,10, Cécile Laroche11, Aldo Pietro Maggioni12, Massimo F Piepoli13, Andrew J S Coats14, Roberto Ferrari15,16, Luigi Tavazzi16. 1. Cardiology Unit, Department of Internal Medicine, University of Genoa, and Ospedale Policlinico San Martino, Genoa, Italy. 2. I Klinika Kardiologii Uniwersytetu Medycznego w Poznaniu, Poznan, Poland. 3. Klinika Kardiologii UM, Szpital Sterlinga, Lodz, Poland. 4. Hospital Universitario Virgen Macarena, Cardiology, Sevilla, Spain. 5. Unidad de Insuficiencia Cardiaca y Cardiopatias Familiars, U.G.C. de Cardiologia y Cirugia Cardiovascular, Ibima, Malaga, Spain. 6. Military Hospital, State Health Centre, Budapest, Hungary. 7. Cardiology Division, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy. 8. University Paris 7, Assistance Publique-Hôpitaux de Paris, U942 Inserm, Paris, France. 9. Division of Cardiology, General Hospital Murska Sobota, Slovenia. 10. Faculty of Medicine, University of Ljubljana, Slovenia. 11. EURObservational Research Programme, European Society of Cardiology, Sophia-Antipolis, France. 12. ANMCO Research Centre, Florence, Italy. 13. Heart Failure Unit, Cardiac Department, Guglielmo da Saliceto Hospital, AUSL Piacenza, Italy. 14. Monash University, Australia and University of Warwick, Coventry, UK. 15. Centro Cardiologico Universitario e LTTA Centre, University of Ferrara, Italy. 16. Maria Cecilia Hospital, GVM Care & Research - E.S. Health Science Foundation, Cotignola (RA), Italy.
Abstract
AIMS: To describe the characteristics and assess the 1-year outcomes of hospitalized (HHF) and chronic (CHF) heart failure patients with chronic obstructive pulmonary disease (COPD) enrolled in a large European registry between May 2011 and April 2013. METHODS AND RESULTS: Overall, 1334/6920 (19.3%) HHF patients and 1322/9409 (14.1%) CHF patients were diagnosed with COPD. In both groups, patients with COPD were older, more frequently men, had a worse clinical presentation and a higher prevalence of co-morbidities. In HHF, the increase in the use of heart failure (HF) medications at hospital discharge was greater in non-COPD than in COPD for angiotensin-converting enzyme inhibitors (+13.7% vs. +7.2%), beta-blockers (+20.6% vs. +11.8%) and mineralocorticoid receptor antagonists (+20.9% vs. +17.3%), thus widening the gap in HF treatment already existing between the two groups at admission. In CHF patients, there was a similar increase in the use of these medications after enrollment visit in the two groups, leaving a significant difference of 8.2% for beta-blockers in favour of non-COPD patients (89.8% vs. 81.6%, P < 0.001). At 1-year follow-up, the hazard ratios for COPD in multivariable analysis confirmed its independent association with hospitalizations both in HHF [all-cause: 1.16 (1.04-1.29), for HF: 1.22 (1.05-1.42)] and CHF patients [all-cause: 1.26 (1.13-1.41), for HF: 1.37 (1.17-1.60)]. The association between COPD and all-cause mortality was not confirmed in both groups after adjustments. CONCLUSIONS: COPD frequently coexists in HHF and CHF, worsens the clinical course of the disease, and significantly impacts its therapeutic management and prognosis. The matter should deserve greater attention from the cardiology community.
AIMS: To describe the characteristics and assess the 1-year outcomes of hospitalized (HHF) and chronic (CHF) heart failurepatients with chronic obstructive pulmonary disease (COPD) enrolled in a large European registry between May 2011 and April 2013. METHODS AND RESULTS: Overall, 1334/6920 (19.3%) HHF patients and 1322/9409 (14.1%) CHFpatients were diagnosed with COPD. In both groups, patients with COPD were older, more frequently men, had a worse clinical presentation and a higher prevalence of co-morbidities. In HHF, the increase in the use of heart failure (HF) medications at hospital discharge was greater in non-COPD than in COPD for angiotensin-converting enzyme inhibitors (+13.7% vs. +7.2%), beta-blockers (+20.6% vs. +11.8%) and mineralocorticoid receptor antagonists (+20.9% vs. +17.3%), thus widening the gap in HF treatment already existing between the two groups at admission. In CHFpatients, there was a similar increase in the use of these medications after enrollment visit in the two groups, leaving a significant difference of 8.2% for beta-blockers in favour of non-COPD patients (89.8% vs. 81.6%, P < 0.001). At 1-year follow-up, the hazard ratios for COPD in multivariable analysis confirmed its independent association with hospitalizations both in HHF [all-cause: 1.16 (1.04-1.29), for HF: 1.22 (1.05-1.42)] and CHFpatients [all-cause: 1.26 (1.13-1.41), for HF: 1.37 (1.17-1.60)]. The association between COPD and all-cause mortality was not confirmed in both groups after adjustments. CONCLUSIONS: COPD frequently coexists in HHF and CHF, worsens the clinical course of the disease, and significantly impacts its therapeutic management and prognosis. The matter should deserve greater attention from the cardiology community.
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Authors: Ovidiu Chioncel; Sean P Collins; Andrew P Ambrosy; Peter S Pang; Elena-Laura Antohi; Vlad Anton Iliescu; Aldo P Maggioni; Javed Butler; Alexandre Mebazaa Journal: Am J Ther Date: 2018 Jul/Aug Impact factor: 2.688
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