P232 Short-term outcomes in heart failure patients with chronic obstructive pulmonary disease in the community

    loading  Checking for direct PDF access through Ovid

Abstract

Aims

Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are common co-morbidities. The combination presents diagnostic challenges and has been linked with worse prognosis in patients admitted to hospital. There is hardly any prognostic data in patients with both co-morbidities in the community.

Methods and Results

We evaluated 783 patients (27.2%) with left ventricular systolic dysfunction under the care of a regional nurse-led community HF team between June 2007 and June 2010. 101 patients (12.9%) also had a diagnosis of COPD. 94% of patients were on loop diuretics; 83% on ACE inhibitors, 74% on β-blockers; 10.6% were on bronchodilators and 42% on aldosterone antagonists. Mean age of the patients was 77.9±5.7 years; 43% were females and mean NYHA class was 2.3±0.6. Mean follow-up was 28.2±2.9 months. β-Blocker utilisation was markedly lower in patients receiving bronchodilators compared to those without (overall 21.7% vs 81%; p<0.001). 24-month survival (Abstract P232 figure 1) was 93% in patients with HF alone and 89% in those with both co-morbidities (p=NS). The presence of COPD was associated with increased HF hospitalisations [HR 1.56 (1.4 to 2.1); p<0.001] and major adverse cardiovascular events [HR 1.23 (1.03 to 1.75); p<0.001].

Conclusions

COPD is a common co-morbidity in ambulatory HF patients in the community and is a powerful predictor of worsening HF. It does not however appear to affect short-term mortality in ambulatory HF patients.

Related Topics

    loading  Loading Related Articles