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Göteborgs universitets publikationer

The Impact of Chronic Obstructive Pulmonary Disease in Patients Hospitalized for Worsening Heart Failure With Reduced Ejection Fraction: An Analysis of the EVEREST Trial

Författare och institution:
R. J. Mentz (-); P. H. Schmidt (-); M. J. Kwasny (-); A. P. Ambrosy (-); C. M. O'Connor (-); M. A. Konstam (-); F. Zannad (-); A. P. Maggioni (-); Karl Swedberg (Institutionen för medicin); M. Gheorghiade (-)
Publicerad i:
Journal of Cardiac Failure, 18 ( 7 ) s. 515-523
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
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 beta-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. CI Cardiac Fail 2012;18:515-523)
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
COPD, heart failure, hospitalization, outcomes, beta-adrenoceptor agonists, quality-of-care, vasopressin antagonism, systolic dysfunction, tolvaptan everest, elderly-patients, optimize-hf, mortality, diagnosis, survival
Postens nummer:
Posten skapad:
2012-08-09 14:16

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