Article Text

PDF

Models of care delivery
P232 Short-term outcomes in heart failure patients with chronic obstructive pulmonary disease in the community
  1. S Ghosh1,
  2. N O Kelly2,
  3. J Smith2,
  4. J Dexter2,
  5. C Carroll-Hawkins2,
  6. W Robertson1
  1. 1University of Leicester, Leicester, UK
  2. 2Leicestershire Partnership NHS Trust, Leicestershire, UK

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].

Abstract P232 Figure 1

Kaplan–Meier survival curve in patients with heart failure, comparing those with and without chronic obstructive pulmonary disease for June 2007 to June 2010.

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.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.