Characteristics and treatment of patients with comorbid COPD and heart failure

David Price, Ronan Ryan, Robert Fogel, Hui Cao, Janwillem W.H. Kocks, Piergiuseppe Agostoni, Chin Kook Rhee, John R. Hurst, Rupert Jones, Konstantinos Kostikas

OnderzoeksoutputAcademic

Samenvatting

Background: Comorbid heart failure (HF) is common in patients with COPD (2.6 times greater odds vs. non-COPD) and may result in different disease management.

Objective: To examine associations between COPD and HF with regard to disease burden and factors affecting treatment adequacy.

Methods: This multiphase study used anonymised, longitudinal data from two large UK health care databases to identify patients ≥40 years old with COPD, HF, or both COPD+HF. Other chronic respiratory diagnoses were exclusions. Cohorts were matched using direct matching methods.

Results: In matched cohorts of 4831 patients, the MRC dyspnoea score in COPD+HF vs. COPD cohorts was 4 or 5 for 19% vs. 11% of patients, respectively (p<0.001). Patients with HF and new COPD were as likely to receive adequate COPD therapy (long-acting bronchodilators) as those with only COPD (adjusted hazard ratio 1.04; 95% CI 0.98–1.11). Patients with COPD and new HF (matched cohorts, n=5877) were less likely to receive adequate HF therapy (β-blockers) than those with only HF (36% vs. 58%; p<0.001). Of those with pre-existing HF, women, current smokers, non-obese patients, and those with poor recording of disease severity were less likely to be adequately treated for new COPD. 

Conclusions: Patients with COPD+HF are more breathless than those with only COPD, and patients with comorbid COPD and HF often receive suboptimal COPD or HF treatment.

Originele taal-2English
DOI's
StatusPublished - sep.-2018
Extern gepubliceerdJa
Evenement28th International Congress of the European-Respiratory-Society (ERS) - Paris, France
Duur: 15-sep.-201819-sep.-2018

Conference

Conference28th International Congress of the European-Respiratory-Society (ERS)
Land/RegioFrance
StadParis
Periode15/09/201819/09/2018

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