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Internal and Emergency Medicine

, Volume 13, Issue 3, pp 351–357 | Cite as

Prognostic influence of prior chronic obstructive pulmonary disease in patients admitted for their first episode of acute heart failure

  • Karine Luz Londoño
  • Francesc Formiga
  • David Chivite
  • Rafael Moreno-Gonzalez
  • Margherita Migone De Amicis
  • Xavier Corbella
IM - ORIGINAL
  • 113 Downloads

Abstract

Chronic obstructive pulmonary disease (COPD) is a frequent comorbidity in heart failure (HF) patients. Whether a prior COPD diagnosis influences patients’ prognosis in early stages of HF is unknown. We reviewed patients > 50 years old admitted because of a first episode of acute HF. We divided the sample into two groups according to the existence of a prior diagnosis of COPD. We used regression analysis to identify the baseline patients’ characteristics associated with the presence of COPD, and Cox mortality analysis to identify baseline and discharge data related to higher risk of a combined outcome of 1-year all-cause readmission or mortality. Finally, 985 patients were included in the analysis; 212 (21.5%) with a prior diagnosis of COPD. Baseline characteristics were similar between both groups except for a much higher prevalence of male gender, higher number of chronic therapies, and lower prevalence of atrial fibrillation among COPD patients. The combined primary outcome is significantly more prevalent in COPD patients (68.4 vs. 59.8%, p = 0.022). Cox analysis identified this prior diagnosis of COPD (HR 1.282, 95% CI 1.063–1.547; p = 0.001) as an independent risk factor for 1-year readmission and mortality, together with older age, higher admission creatinine and potassium values, and a higher number of chronic therapies. Our study confirms that in a “real-life” cohort of elderly patients experiencing a first episode of acute HF, the presence of a prior diagnosis of COPD is common, and confers a higher risk of adverse outcomes (death or readmission) during the year following discharge.

Keywords

Heart failure Chronic obstructive pulmonary disease Hospitalizations Readmissions Mortality 

Notes

Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with animals performed by any of the authors. The ethics committee of the Bellvitge University Hospital approved the overall protocol.

Informed consent

For this type of study formal consent is not required.

References

  1. 1.
    Ruiz-Laiglesia FJ, Garcés-Horna V, Formiga F (2016) Comprehensive therapeutic approach for patients with heart failure and comorbidity. Rev Clin Esp 216:323–330CrossRefPubMedGoogle Scholar
  2. 2.
    Hillas G, Perlikos F, Tsiligianni L, Tzanakis N (2015) Managing comorbidities in COPD. Int J Chronic Obstr Pulm Dis 10:95–109Google Scholar
  3. 3.
    Staszewsky L, Cortesi L, Tettamanti M, Dal Bo GA, Fortino I, Bortolotti A, Merlino L, Latini R, Roncaglioni MC, Baviera M (2016) Outcomes in patients hospitalized for heart failure and chronic obstructive pulmonary disease: differences in clinical profile and treatment between 2002 and 2009. Eur J Heart Fail 18:840–848CrossRefPubMedGoogle Scholar
  4. 4.
    Fisher K, Stefan MF, Darling D, Lessard D, Goldberg RJ (2015) Impact of COPD on the mortality and treatment of patients hospitalized with acute decompensated heart failure: the worcester heart failure study. Chest 2015:637–645CrossRefGoogle Scholar
  5. 5.
    Cooper LB, Mentz RJ (2015) COPD in heart failure: are there long-term implications following acute heart failure hospitalization? Chest 147:586–588CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    O’Kelly N, Robertson W, Smith J, Dexter J, Carroll-Hawkins C, Ghosh S (2012) Short-term outcomes in heart failure patients with chronic obstructive pulmonary disease in the community. World J Cardiol 4:66–71CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Maggioni AP (2015) Epidemiology of heart: failure in Europe. Heart Fail Clin 11:625–635CrossRefPubMedGoogle Scholar
  8. 8.
    Jacob J, Tost J, Miró O, Herrero P, Martin-Sánchez FJ, Llorens P (2017) Impact of chronic obstructive pulmonary disease on clinical course after an episode of acute heart failure. EAHFE-COPD study. Int J Cardiol 227:450–456CrossRefPubMedGoogle Scholar
  9. 9.
    Migone de Amicis M, Chivite D, Corbella X, Cappellini MD, Formiga F (2017) Anemia is a mortality prognostic factor in patients initially hospitalized for acute heart failure. Intern Emerg Med 12:749–756CrossRefPubMedGoogle Scholar
  10. 10.
    Canepa M, Temporelli PL, Rossi A, Rossi A, Gonzini L, Nicolosi GL, Staszewsky L, Marchioli R, Maggioni AP, Tavazzi LI, GISSI-HF Investigators (2017) Prevalence and prognostic impact of chronic obstructive pulmonary disease in patients with chronic heart failure: data from the GISSI-HF trial. Cardiology 136:128–137CrossRefPubMedGoogle Scholar
  11. 11.
    Hawkins NM, Virani S, Ceconi C (2013) Heart failure and chronic obstructive pulmonary disease: the challenges facing physicians and health services. Eur Heart J 34:2795–2803CrossRefPubMedGoogle Scholar
  12. 12.
    Hawkins NM, Petrie MC, Jhund PS, Chalmers GW, Dunn FG, McMurray JJ (2009) Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology. Eur J Heart Fail 11:130–139CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Aryal S, Diaz-Guzman E, Mannino DM (2014) Influence of sex on chronic obstructive pulmonary disease risk and treatment outcomes. Int J Chronic Obstr Pulm Dis 9:1145–1154Google Scholar
  14. 14.
    Konecny T, Park JY, Somers KR, Konecny D, Orban M, Soucek F, Parker KO, Scanlon PD, Asirvatham SJ, Brady PA, Rihal CS (2014) Relation of chronic obstructive pulmonary disease to atrial and ventricular arrhythmias. Am J Cardiol 114:272–277CrossRefPubMedGoogle Scholar
  15. 15.
    Lipworth B, Skinner D, Devereux G, Thomas V, Ling Zhi Jie J, Martin J, Carter V, Price DB (2016) Underuse of β-blockers in heart failure and chronic obstructive pulmonary disease. Heart 2016(102):1909–1914CrossRefGoogle Scholar
  16. 16.
    Puente-Maestu L, Alvarez-Sala LA, De Miguel-Díez J (2015) Beta-blockers in patients with chronic obstructive disease and coexistent cardiac illnesses. COPD Res Pract 1:11CrossRefGoogle Scholar
  17. 17.
    Desai AS, Stevenson LW (2012) Rehospitalization for heart failure. Predict or prevent? Circulation 126:501–506CrossRefPubMedGoogle Scholar
  18. 18.
    Staszewsky L, Wong M, Masson S, Barlera S, Carretta E, Maggioni AP, Anand IS, Cohn JN, Tognoni G, Latini R, Valsartan Heart Failure Trial Investigators (2007) Clinical, neurohormonal, and inflammatory markers and overall prognostic role of chronic obstructive pulmonary disease in patients with heart failure: data from the Val-HeFT heart failure trial. J Card Fail 13:797–804CrossRefPubMedGoogle Scholar
  19. 19.
    Hawkins NM, Huang Z, Pieper KS, Solomon SD, Kober L, Velazquez EJ, Swedberg K, Pfeffer MA, McMurray JJ, Maggioni AP, Valsartan in Acute Myocardial Infarction Trial Investigators (2009) Chronic obstructive pulmonary disease is an independent predictor of death but not atherosclerotic events in patients with myocardial infarction: analysis of the Valsartan in Acute Myocardial Infarction Trial (VALIANT). Eur J Heart Fail 11:292–298CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Hawkins NM, Wang D, Petrie MC, Pfeffer MA, Swedberg K, Granger CB, Yusuf S, Solomon SD, Ostergren J, Michelson EL, Pocock SJ, Maggioni AP, McMurray JJ, CHARM Investigators Committees (2010) Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM programme. Eur J Heart Fail 2010(12):557–565CrossRefGoogle Scholar
  21. 21.
    Ukena C, Mahfoud F, Kindermann M, Kindermann I, Bals R, Voors AA, van Veldhuisen DJ, Böhm M (2010) The cardiopulmonary continuum systemic inflammation as ‘common soil’ of heart and lung disease. Int J Cardiol 145:172–176CrossRefPubMedGoogle Scholar
  22. 22.
    Rossi A, Aisanov Z, Avdeev S, Di Maria G, Donner CF, Izquierdo JL, Roche N, Similowski T, Watz H, Worth H, Miravitlles M (2015) Mechanisms, assessment and therapeutic implications of lung hyperinflation in COPD. Respir Med 2015:785–802CrossRefGoogle Scholar
  23. 23.
    Güder G, Rutten FH (2014) Comorbidity of heart failure and chronic obstructive pulmonary disease: more than coincidence. Curr Heart Fail Rep 11:337–346CrossRefPubMedGoogle Scholar
  24. 24.
    Chhabra SK, Gupta M (2010) Coexistent chronic obstructive pulmonary disease-heart failure: mechanisms, diagnostic and therapeutic dilemmas. Indian J Chest Dis Allied Sci 52:225–238PubMedGoogle Scholar
  25. 25.
    Mozzini C, Di Dio Perna M, Pesce G, Garbin U, Fratta Pasini AM, Ticinesi A, Nouvenne A, Meschi T, Casadei A, Soresi M, Cominacini L (2018) Lung ultrasound in internal medicine efficiently drives the management of patients with heart failure and speeds up the discharge time. Intern Emerg Med 13:27–33CrossRefPubMedGoogle Scholar
  26. 26.
    Marcun R, Stankovic I, Vidakovic R, Farkas J, Kadivec S, Putnikovic B, Ilic I, Neskovic AN, Lainscak M (2011) Prognostic implications of heart failure with preserved ejection fraction in patients with an exacerbation of chronic obstructive pulmonary disease. Intern Emerg Med 11:519–527CrossRefGoogle Scholar

Copyright information

© SIMI 2018

Authors and Affiliations

  1. 1.Médica Universidad LibreCaliColombia
  2. 2.Geriatric Unit, Internal Medicine DepartmentUniversitary Hospital Bellvitge-IDIBELL, L’ Hospitalet de LlobregatBarcelonaSpain
  3. 3.Scuola di Specializzazione in Medicina InternaUniversità degli Studi di MilanoMilanItaly
  4. 4.Faculty of Medicine and Health SciencesUniversitat Internacional de CatalunyaBarcelonaSpain

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