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European Journal of Heart Failure 2007 9(9):942-948; doi:10.1016/j.ejheart.2007.06.004
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© 2007 European Society of Cardiology

The prognostic influence of chronic obstructive pulmonary disease in patients hospitalised for chronic heart failure

Alejandro Macchia*, Simona Monte, Marilena Romero, Antonio D'Ettorre and Gianni Tognoni

Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud Santa Maria Imbaro, Chieti, Italy

* Corresponding author. Tel.: +39 0872570300; fax: +39 0872570248. E-mail address: macchia{at}negrisud.it


  Abstract

Aims: To investigate the prevalence and the prognostic impact of chronic obstructive pulmonary disease (COPD), in patients hospitalised with chronic heart failure (CHF).

Methods and results: In an observational study based on longitudinal information from administrative registers, 1020 patients aged ≥60 years, who were chronically treated for and hospitalised with CHF were identified and followed-up for major events up to 1 year.

Median age was 80 years, half of the patients were female and 241 patients (23.6%) had concomitant COPD. There were no differences in the prevalence of cardiovascular and non-cardiovascular comorbidities between CHF patients with or without COPD. However, COPD patients were more often male (60.6% vs. 46.3%), more frequently treated with diuretics (95.9% vs. 91.5%) but less often exposed to β-blockers (16.2% vs. 22.0%). Significantly higher adjusted in-hospital (HR 1.50 [95%CI 1.00–2.26]) and out-of-hospital (1.42 [1.09–1.86]) mortality rates were found in CHF patients with concomitant COPD. A higher occurrence of non-fatal AMI/stroke/rehospitalisation for CHF (1.26 [1.01–1.58]) as well as hospitalisation for CHF (1.35 [1.00–1.82]) was associated with COPD.

Conclusions: COPD is a frequent concomitant disease in patients with heart failure and it is an independent short-term prognostic indicator of mortality and cardiovascular comorbidity in patients who have been admitted to hospital for heart failure.

Key Words: Medical record-linkage • Chronic heart failure • Chronic obstructive pulmonary disease

Received November 19, 2006; Revised March 21, 2007; Accepted June 7, 2007


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