Clinical characteristics and outcomes of hospitalized heart failure patients with systolic dysfunction and chronic obstructive pulmonary disease: Findings from OPTIMIZE-HF

Robert J. Mentz*, Mona Fiuzat, Daniel M. Wojdyla, Karen Chiswell, Mihai Gheorghiade, Gregg C. Fonarow, Christopher M. Oconnor

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

73 Scopus citations

Abstract

Aims: Chronic obstructive pulmonary disease (COPD) is common in heart failure (HF) patients, yet the population is poorly characterized and associated with conflicting outcomes data. We aimed to evaluate the clinical characteristics and outcomes of HF patients with systolic dysfunction and COPD in a large acute HF registry. Methods and results: OPTIMIZE-HF (Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure) was a performance-improvement registry of patients hospitalized with HF (n 48 612), which included a pre-specified subgroup of patients (n 5,701) with 60-to 90-day follow-up. We performed a retrospective analysis of the clinical characteristics and outcomes (length of stay, and in-hospital and 60-day mortality) of patients with systolic dysfunction according to baseline COPD status. COPD was present in 25 of the patients. These patients had more co-morbidities compared with patients without COPD. They were less likely to receive a beta-blocker or angiotensin-converting enzyme inhibitor during hospitalization and at discharge (P < 0.001). COPD was associated with an increased median length of stay [5 days (interquartile range 38) vs. 4 days (interquartile range 37), P < 0.0001] and increased in-hospital all-cause and non-cardiovascular (CV) mortality, with rates of 4.5 vs. 3.7 (P 0.01) and 1.0 vs. 0.6 (P 0.01), respectively, for the two endpoints, but similar 60-day mortality (6.2 vs. 6.0, P 0.28). After risk adjustment, the in-hospital non-CV mortality remained increased (odds ratio 1.65, 95 confidence interval 1.122.41; P 0.01). Conclusion: The presence of COPD in HF patients with systolic dysfunction is associated with an increased burden of co-morbidities, lower use of evidence-based HF medications, longer hospitalizations, and increased in-hospital non-CV mortality, but similar post-discharge mortality. Published on behalf of the European Society of Cardiology. All rights reserved.

Original languageEnglish (US)
Pages (from-to)395-403
Number of pages9
JournalEuropean Journal of Heart Failure
Volume14
Issue number4
DOIs
StatePublished - Apr 2012

Keywords

  • COPD
  • Heart failure
  • Outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Clinical characteristics and outcomes of hospitalized heart failure patients with systolic dysfunction and chronic obstructive pulmonary disease: Findings from OPTIMIZE-HF'. Together they form a unique fingerprint.

Cite this