Acutely decompensated heart failure with chronic obstructive pulmonary disease: Clinical characteristics and long-term survival

Scrutinio, Domenico; Guida, Pietro; Passantino, Andrea; Ammirati, Enrico; Oliva, Fabrizio; Lagioia, Rocco; Raimondo, Rosa; Venezia, Mario; Frigerio, Maria

doi:10.1016/j.ejim.2018.11.002

Cited by 7 publications

(6 citation statements)

References 58 publications

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“…A multicenter prospective cohort study showed no differences in inpatient mortality between patients with coexistent COPD and HF and patients with HF alone [26]. However, mortality at 1 year was higher in patients with coexistent COPD, likely because they received less evidence-based care for HF, such as lack of beta blockers, due to the presumed contraindication in patients with COPD [26,27]. Similarly, we found that COPD fails to predict inpatient mortality in patients with ADHF.…”

Section: Discussionmentioning

confidence: 52%

Predictability of Inpatient Mortality of Different Comorbidities in Both Types of Acute Decompensated Heart Failure: Analysis of National Inpatient Sample

et al. 2021

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Background: Several prediction models have been proposed to assess the short outcomes and in-hospital mortality among patients with heart failure (HF). Several variables were used in common among those models. We sought to focus on other, yet important risk factors that can predict outcomes. We also sought to stratify patients based on ejection fraction, matching both groups with different risk factors. Methods:We conducted a retrospective cohort study utilizing the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) 2016 database.Results: There were totally 116,189 admissions for acute decompensated heart failure (ADHF). Of these, 50.9% were for heart failure with reduced ejection fraction (HFrEF) group (n = 59,195), and 49.1% were for heart failure with preserved ejection faction (HFpEF) group (n = 56,994). Overall, in-hospital mortality was 2.5% of admissions for ADHF (n = 2,869). When stratified by HF types, admissions for HFrEF had higher mortality rate (2.7%, n = 1,594) in comparison to admissions for HFpEF (2.2%, n = 1,275) (P < 0.001). Significantly associated variables in univariate analyses were age, race, hypertension, diabetes mellitus, chronic kidney disease (CKD), atrial fibrillation/flutter, obesity, and chronic ischemic heart disease (IHD), while gender and chronic obstructive pulmonary disease (COPD) did not achieve statistical significance (P > 0.1). Conclusions:To our knowledge, this is the first study to stratify HF patients based on ejection fraction and utilizing different predictors and in-hospital mortality. These and other data support the need for future research to utilize these predictors to create more accurate models in the future.

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Section: Discussionmentioning

confidence: 52%

Predictability of Inpatient Mortality of Different Comorbidities in Both Types of Acute Decompensated Heart Failure: Analysis of National Inpatient Sample

et al. 2021

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“…Beta blockers induce fewer myocardial infarctions than calcium blockers, and beta blockers have fewer cardiovascular hospitalizations than digoxin [ 32 ]. In patients with COPD compared with non-COPD patients, the use of beta blockers at discharge significantly reduced 1-year mortality after discharge (SHR 0.66, 95% CI: 0.53–0.83) [ 33 ]. However, past studies with congestive heart failure combined with COPD have found that the presence of COPD significantly reduces the prescription of beta blockers at discharge.…”

Section: Discussionmentioning

confidence: 99%

New-Onset Atrial Fibrillation Is a Risk Factor of Ischemic Stroke in Chronic Obstructive Pulmonary Disease

et al. 2022

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Chronic obstructive pulmonary disease (COPD) induces atrial fibrillation (AF) and stroke, and COPD with AF increased ischemic stroke (IS) in a cross-sectional study. Therefore, healthcare providers must be concerned and well-informed about this particular situation. For this study, inpatient data were obtained from the Taiwan National Health Insurance Database in 2010. We identified patients who were hospitalized with COPD (International Classification of Disease, Ninth Revision, Clinical Modification [ICD-9-CM] is 491, 492, and 496). Patients who experienced AF (ICD-9-CM to 427.3) during the same admission or after COPD hospitalization were discharged and defined as new-onset AF. The outcome was IS (ICD-9-CM as 433–437). The factors related to IS after COPD were used for multivariate logistic regression. There were 4177/62163 (6.72%) patients with incident IS. The risk of IS after COPD hospitalization was shown to have an adjusted odds ratio of 1.749 (95% CI: 1.584–1.93, p < 0.001) for patients with new-onset AF. Other factors included advanced age, atherosclerosis factors, comorbidity severity, sepsis and lower-level hospital admission. In conclusion, COPD patients suffering from new-onset AF had an increased incidence of IS in the population observation study. New-onset AF was an omit risk factor for IS in COPD in the Chinese population.

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“…COPD is considered an emerging cardiovascular risk factor [33][34][35] ; however, whether coexisting COPD is an independent prognostic factor in the general HF population remains contentious. [36][37][38][39][40][41] Some studies showed an association between coexisting COPD and mortality in HF, [36][37][38] whereas others failed to demonstrate the prognostic significance of COPD in HF. [39][40][41] These discrepancies might be related to the different clinical situations in these studies, and careful interpretation of each study is required.…”

Section: Discussionmentioning

confidence: 99%

Younger‐ vs Older‐Old Patients with Heart Failure with Preserved Ejection Fraction

Matsushita

Harada

Miyazaki

et al. 2019

J American Geriatrics Society

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OBJECTIVES Heart failure with preserved ejection fraction (HFpEF) is now recognized as a geriatric syndrome with multifactorial pathophysiology and clinical heterogeneity rather than a solely left ventricular diastolic dysfunction. Because the pathophysiology of HFpEF is suggested to differ by age, this study compared the clinical characteristics and prognostic factors between HFpEF patients aged 65 to 84 years and those aged 85 years or older. DESIGN Retrospective cohort study. SETTING The Tokyo CCU Network including 73 hospitals in Tokyo, Japan. PARTICIPANTS Individuals aged 65 years or older with HFpEF (N = 4305). MEASUREMENTS Very old patients were defined as those aged 85 years or older. Potential risk factors for in‐hospital mortality were selected by univariate analyses, and those with a P value <.10 were used in multivariate Cox regression analysis with forward selection (likelihood ratio) to identify significant factors. RESULTS Prevalence of hypertension was significantly higher in very old patients, whereas prevalence of coronary artery disease, diabetes mellitus, hyperlipidemia, and smoking was significantly higher in patients aged 65 to 84 years. In very old patients, low systolic blood pressure (hazard ratio [HR] = .988), high serum creatinine level (HR = 1.34), and coexisting chronic obstructive pulmonary disease (COPD; HR = 2.01) were identified as independent risk factors for in‐hospital mortality. In contrast, low systolic blood pressure (HR = .987) and low body mass index (HR = .935) were identified as independent risk factors in patients aged 65 to 84 years. CONCLUSION Significant differences were observed in the clinical characteristics and prognostic factors for in‐hospital mortality between HFpEF patients aged 65 to 84 and those 85 years and older. Of note, coexisting COPD was associated with significantly lower survival rate only in patients aged 85 years and older, suggesting the prognostic impact of concomitant pulmonary disease in HFpEF may increase with age. These results have implications for future research and management of older HFpEF patients. J Am Geriatr Soc 00:1–6, 2019. J Am Geriatr Soc 67:2123–2128, 2019

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Acutely decompensated heart failure with chronic obstructive pulmonary disease: Clinical characteristics and long-term survival

Cited by 7 publications

References 58 publications

Predictability of Inpatient Mortality of Different Comorbidities in Both Types of Acute Decompensated Heart Failure: Analysis of National Inpatient Sample

Predictability of Inpatient Mortality of Different Comorbidities in Both Types of Acute Decompensated Heart Failure: Analysis of National Inpatient Sample

New-Onset Atrial Fibrillation Is a Risk Factor of Ischemic Stroke in Chronic Obstructive Pulmonary Disease

Younger‐ vs Older‐Old Patients with Heart Failure with Preserved Ejection Fraction

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