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

Table 1 Baseline clinical characteristics of patients with heart failure, comparing those with and without chronic obstructive pulmonary disease for June 2007 to June 2010 (SD)

Baseline features	HF patients with COPD	HF patients without COPD
	(n = 101)	(n = 682)
Age, yr	75.8 (6.9)b	71.3 (4.4)
Gender (M/F, %)	58/42	56/44
LVEF, %	33.6 (10.7)b	38.9 (4.8)
Ischemic cause, %	64.5 (4.8)	68.9 (10.2)
Duration of HF, yr	7.2 (2.3)	5.9 (4.2)
Duration of COPD, yr	6.9 (1.6)	----
NYHA status	2.6 (1.2)	2.4 (1.4)
FEV1/FVC ratio, %	53.6 (7.4)	----
Heart rate	71.4 (12.8)	73.4 (11.8)
Blood pressure, mmHg	125 (17.2)/76 (10.1)	129 (11.4)/81 (9.3)
eGFR	57.4 (12.9)	60.2 (13.5)
BMI	23.8 (5.3)	24.6 (3.9)

HF: Heart failure; COPD: Chronic obstructive pulmonary disease; eGFR: Estimated glomerular filtration rate; LVEF: Left ventricular ejection fraction; BMI: Body mass index; FEV: Forced expiratory volume; FVC: Forced vital capacity.

^bP < 0.01 vs patients without COPD.

Table 2 Comorbidity in patients with heart failure, comparing those with and without chronic obstructive pulmonary disease for June 2007 to June 2010 n (%)

Condition	HF patients with COPD(n = 101)	HF patients without COPD(n = 682)
Cardiovascular risk factors
Diabetes	17 (17)	136 (20)
Hypertension	43 (43)b	382 (56)
Dyslipidemia	24 (24)	177 (26)
Smoker	57 (57)b	164 (25)
Ex-smoker	31 (31)b	136 (20)
Cardiovascular disease
Previous MI	27 (27)	198 (29)
Angina	49 (49)	355 (53)
Previous stroke	20 (20)	130 (19)
Atrial fibrillation	21 (21)b	184 (27)
Non-cardiovascular factors
Cancer	24 (24)	177 (26)
Depression	31 (31)b	143 (21)

MI: Myocardial infarction; HF: Heart failure; COPD: Chronic obstructive pulmonary disease.

^bP < 0.01 vs patients without COPD.

Table 3 Pharmacological treatments of patients with heart failure, comparing those with and without chronic obstructive pulmonary disease for June 2007 to June 2010 n (%)

Treatment	HF patients with COPD (n = 101)	HF patients without COPD (n = 682)
Cardiovascular treatment
Beta-blocker	21 (22)b	555 (81)
ACE-inhibitor	49 (49)	382 (56)
Angiotensin receptor blocker	11 (11)	82 (12)
Spironolactone	54 (54)b	189 (28)
Loop diuretic	61 (61)b	525 (77)
Calcium channel blocker	31 (31)	184 (27)
Amiodarone	5 (5)	41 (6)
Aspirin	60 (60)	436 (64)
Warfarin	15 (15)b	130 (20)
COPD treatment
Beta agonist	61 (61)b	20 (3)
Inhaled anti-muscarinic	27 (27)b	6 (1)
Inhaled steroid	53 (53)b	19 (3)
Oral steroids	24 (24)b	2 (0.003)

HF: Heart failure; COPD: Chronic obstructive pulmonary disease.

^bP < 0.01 vs patients without COPD.

Table 4 Association between chronic obstructive pulmonary disease diagnosis and clinical outcomes in the patient cohort for June 2007 to June 2010

Outcome	COPD and HF	HF alone	Unadjusted HR (95% CI)	P value	Adjusted HR (95% CI)	P value
HF hospitalization	36 (36)	143 (21)	1.78 (1.49-2.11)	< 0.001	1.56 (1.4-2.1)	< 0.001
All-cause mortality	29 (29)	177 (26)	1.07 (0.89-1.54)	0.428	1.02 (0.77-1.5)	0.225
Major CV events (non-fatal MI, stroke)	19 (19)	61 (9)	1.34 (1.1-1.53)	< 0.001	1.23 (1.03-1.75)	< 0.001
CV death	22 (22)	155 (23)	0.92 (0.68-1.06)	0.357	0.96 (0.77-1.13)	0.149

HF: Heart failure; COPD: Chronic obstructive pulmonary disease; HR: Hazard ratio; CV: Cardiovascular; MI: Myocardial infarction.