The impact of chronic obstructive pulmonary disease in patients hospitalized for worsening heart failure with reduced ejection fraction: an analysis of the EVEREST Trial.

Journal Article

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is prevalent in heart failure (HF) patients, yet these patients are poorly characterized. We aimed to describe the characteristics and outcomes of patients with systolic dysfunction and COPD in a contemporary HF randomized trial. METHODS AND RESULTS: EVEREST investigated 4,133 patients hospitalized with worsening HF and an ejection fraction (EF) ≤40%. We analyzed the characteristics and outcomes (all-cause mortality and cardiovascular mortality/HF hospitalization) of patients according to baseline COPD status. COPD was present in 10% (n = 416) of patients. Patients with COPD had a higher prevalence of comorbidities and were less likely to receive a β-blocker, angiotensin-converting enzyme inhibitor, or aldosterone antagonist. On univariate analysis, COPD was associated with increased all-cause mortality (HR 1.41, 95% CI 1.18-1.67) and cardiovascular mortality/HF hospitalization (HR 1.29, 95% CI 1.11-1.49). After adjusting for potential confounders, the risk associated with COPD remained increased, but was not statistically significant. CONCLUSION: The presence of COPD in HF patients is associated with an increased burden of comorbidities, lower use of HF therapies, and a trend toward worse outcomes. These findings provide a starting point for prospective investigations of the treatment of HF comorbidities to reduce the high postdischarge event rates.

Full Text

Duke Authors

Cited Authors

  • Mentz, RJ; Schmidt, PH; Kwasny, MJ; Ambrosy, AP; O'Connor, CM; Konstam, MA; Zannad, F; Maggioni, AP; Swedberg, K; Gheorghiade, M

Published Date

  • July 2012

Published In

Volume / Issue

  • 18 / 7

Start / End Page

  • 515 - 523

PubMed ID

  • 22748484

Electronic International Standard Serial Number (EISSN)

  • 1532-8414

International Standard Serial Number (ISSN)

  • 1071-9164

Digital Object Identifier (DOI)

  • 10.1016/j.cardfail.2012.04.010

Language

  • eng