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The clinical characteristics and outcomes of heart failure patient with chronic obstructive pulmonary disease from the Japanese community-based registry

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Abstract

Both heart failure (HF) and chronic obstructive pulmonary disease (COPD) are common diseases, but few studies have assessed the relationship between COPD and outcomes in patients with acute HF, especially in relation to age or ejection fraction (EF). The Kitakawachi Clinical Background and Outcome of Heart Failure Registry was a prospective, multicenter, community-based cohort and enrolled a total of 1,102 patients with acute HF between 2015 and 2017 in this study. The primary endpoint was defined as a composite endpoint that included all-cause mortality and hospitalization for HF. We stratified patients into two groups: those aged ≥ 80 years (elderly) and < 80 years (nonelderly). HF with preserved EF (HFpEF) was defined as EF ≥ 50%, whereas HF with reduced ejection fraction (HFrEF) was defined as EF < 50%. A total of 159 patients (14.4%) with COPD and 943 patients (83.6%) without COPD were included. COPD was found to be independently associated with a higher risk of the composite endpoint (adjusted hazard ratio: 1.42, 95% confidence interval: 1.14–1.77; p = 0.003). During a subgroup analysis, COPD was exposed as an independent risk factor of the composite endpoint in nonelderly patients; however, there was not such a finding observed among elderly patients. Separately, there was a significant association with COPD and the composite endpoint in patients with HFpEF. COPD showed a significantly higher risk of the composite endpoint after discharge in acute HF. However, this heightened risk was observable only in the subgroup of nonelderly patients and those of HFpEF.

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Acknowledgement

We sincerely appreciate the help of all the institutions participating in the registry and the clinical research coordinators (Takemoto N, Haratani K, Sakata T, Kiguchi A, Matsushita M). We also thank our colleagues from Osaka University Center of Medical Data Science and Advanced Clinical Epidemiology Investigator’s Research Project for their providing insight and expertise for our research.

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Authors and Affiliations

  1. Department of Cardiology, Hirakata Kohsai Hospital, 1-2-1, Fujisakahigashimachi, Hirakata, Osaka, 573-0153, Japan

    Kensuke Takabayashi, Miyuki Okuda, Shouji Kitaguchi & Ryuji Nohara

  2. Department of Internal Medicine, Arisawa General Hospital, Osaka, Japan

    Yuka Terasaki

  3. Department of Cardiology, Hirakata City Hospital, Osaka, Japan

    Osamu Nakajima

  4. Department of Cardiology, Otokoyama Hospital, Kyoto, Japan

    Hitoshi Koito

  5. Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan

    Tetsuhisa Kitamura

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  1. Kensuke Takabayashi
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  2. Yuka Terasaki
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  3. Miyuki Okuda
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  4. Osamu Nakajima
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Correspondence to Kensuke Takabayashi.

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This research was supported by research funding from Nakajima Steel Pipe Company Limited, Osaka Yakugyo Club. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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Takabayashi, K., Terasaki, Y., Okuda, M. et al. The clinical characteristics and outcomes of heart failure patient with chronic obstructive pulmonary disease from the Japanese community-based registry. Heart Vessels 36, 223–234 (2021). https://doi.org/10.1007/s00380-020-01675-0

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