Chronic obstructive pulmonary disease on inpatients with heart failure. GESAIC study results

Background and objective: The clinical relevance of Heart failure (HF) and chronic obstructive pulmonary disease (COPD) in the same patient is not well established. We decided to study the prevalence of COPD in patients admitted due to HF, to define their clinical profile and the relationship with adrenergic beta-blockers (BB) treatment. Patients and method: Prospective cohort of inpatients with HF admitted in 15 Internal Medicine Services from October 2005 to March 2006. Diagnosis of COPD was established according to clinical criteria or spirometry. Data about neurohormonal treatment (before, during the admission, and at discharge) were collected. Statistical analyses were performed using Ji square test and T Student test. A logistic regression model was designed with data. P < 0.05 being considered statistically significant. Results: About 391 patients were included. CPOD was present in 25.1% of patients. In two thirds of patients, the COPD diagnosis was established by clinical criteria. Regarding GOLD, 23.5% of patients had moderate or severe COPD severity. Bivariate analysis showed that male (< 0.05), poor Charlson's Index and overweight (p = 0.04 both) had all relationship with COPD. The regression model indicated that only left ventricular ejection fraction (LVEF) and BB treatment before admission had statistical significance (p = 0.03 and p < 0.001 respectively). At discharge, 27,6% of patients received BB. Conclusions: COPD in HF patients is common and most frequent patients are aged men high comorbidity and overweight. BB treatment is conditioned by LVEF, without relationship with COPD severity. (c) 2009 Elsevier Espana, S.L. All rights reserved.