Influence of chronic obstructive pulmonary disease on long-term hospitalization and mortality in patients with heart failure with reduced ejection fraction

BMC Pulmonary Medicine

Research

Jih-Kai Yeh¹  Yun-Ju Huang²  Pi-Hung Tung³  Bo-Jui Chang³  Chiung-Hung Lin³  Jia-Shiuan Ju³  Yu-Lun Lo³  Ting-Yu Lin³  Tzu-Hsuan Chiu³  Shu-Min Lin⁴ 

[1] Department of Cardiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan;Department of Rheumatology and Immunology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan;Department of Thoracic Medicine, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, 199 Tun-Hwa N. Rd., Taipei, Taiwan;Department of Thoracic Medicine, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, 199 Tun-Hwa N. Rd., Taipei, Taiwan;Department of Respiratory Therapy, School of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan;

关键词: Heart failure;    Reduced ejection fraction;    COPD;    Mortality;    Hospitalization;    Angiotensin-converting enzyme inhibitor;    Angiotensin receptor blocker;   

DOI  :  10.1186/s12890-023-02357-z

 received in 2022-06-19, accepted in 2023-02-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHeart failure with reduced ejection fraction (HFrEF) can coexist with chronic obstructive pulmonary disease (COPD), which complicates the clinical situation and worsens quality of life. The study used standard diagnostic criteria for detecting COPD in hospitalized HFrEF patients and to survey the influence of other comorbidities and medications on the long-term outcomes of HFrEF + COPD patients.MethodsWe retrospectively recruited patients hospitalized due to HFrEF in a tertiary medical center and examined and followed up clinical outcomes, including length of hospital stay, mortality, and readmission episodes, for a 5-year period. Risk factors for mortality were analyzed using multivariate analysis.ResultsOf the 118 hospitalized HFrEF study participants, 68 had concurrent COPD whereas 50 did not. There was a significant increase in the male predominance, smoking history, higher hemoglobin level and increased length of hospital stay in the HF + COPD group than in the HF-only group. Lower left ventricular ejection fraction was found in the HF and COPD comorbidity group. In multivariate analysis, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) use independently associated with a beneficial effect on survival in HF patients with COPD. Oral corticosteroid uses and stroke as a comorbidity were independently associated with a shorter time to the first readmission episode.ConclusionIn HFrEF patients, COPD was associated with a prolonged length of hospital stay. ACEI/ARB use might relate to a beneficial effect on survival in HF patients with COPD. The use of maintenance oral corticosteroid in patients with both HF and COPD should be crucially evaluated to determine the clinical benefit and disadvantages.

【 授权许可】

CC BY   
© The Author(s) 2023

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