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Published on: August 24, 2019
Independent risk factors for mortality in patients with chronic obstructive pulmonary disease who undergo
Young-Hwan Ahn1, Keu Sung Lee, Joo Hun Park
1Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
Insights
Cardiovascular comorbidities significantly impact chronic obstructive pulmonary disease (COPD) prognosis. Lower hemoglobin and left ventricular ejection fraction, along with reduced forced expiratory volume in 1 second (FEV1), are key mortality predictors in COPD patients.
Area of Science:
- Pulmonary Medicine
- Cardiology
- Internal Medicine
Background:
- Cardiovascular disease is the leading cause of mortality in patients with chronic obstructive pulmonary disease (COPD).
- The prognostic implications of cardiovascular comorbidities in COPD remain incompletely understood.
Purpose of the Study:
- To investigate the impact of cardiovascular comorbidities on the prognosis of patients diagnosed with COPD.
- To identify specific cardiovascular factors influencing COPD patient survival.
Main Methods:
- Retrospective cohort study involving 229 COPD patients who underwent comprehensive cardiac evaluations.
- Cardiac evaluations included coronary angiography and echocardiography.
- Survival analyses were conducted using Kaplan-Meier and Cox regression models.
Main Results:
- COPD patients with left heart failure had significantly shorter survival than those without (6.7 vs. 12.5 years).
- Anemia was associated with reduced survival in COPD patients (8.3 vs. 13.8 years).
- Coronary artery disease (CAD) did not significantly affect COPD survival (p=0.703).
- Lower hemoglobin, reduced left ventricular ejection fraction, and lower forced expiratory volume in 1 second (FEV1) were independent predictors of mortality.
Conclusions:
- Hemoglobin levels, left ventricular ejection fraction, and FEV1 are independent risk factors for mortality in COPD patients.
- These findings underscore the need for multidisciplinary management strategies in COPD care.
- Comprehensive cardiac evaluation is crucial for assessing prognosis in COPD patients.
Background:
Cardiovascular disease is the most common cause of death in chronic obstructive pulmonary disease (COPD). However, the impact of cardiovascular comorbidities on the prognosis of COPD is not well known.
Objectives:
This study was performed to investigate the effects of cardiovascular comorbidities on the prognosis of COPD.
Methods:
We enlisted 229 patients with COPD who underwent comprehensive cardiac evaluations including coronary angiography and echocardiography at Ajou University Hospital between January 2000 and December 2012. Survival analyses were performed in this retrospective cohort.
Results:
Kaplan-Meier analyses showed that COPD patients without left heart failure (mean survival = 12.5 ± 0.7 years) survived longer than COPD patients with left heart failure (mean survival = 6.7 ± 1.4 years; p = 0.003), and the survival period of nonanemic COPD patients (mean survival = 13.8 ± 0.8 years) was longer than that of anemic COPD patients (mean survival = 8.3 ± 0.8 years; p < 0.001). The survival period in COPD with coronary artery disease (CAD; mean survival = 11.37 ± 0.64 years) was not different from that in COPD without CAD (mean survival = 11.98 ± 0.98 years; p = 0.703). According to a multivariate Cox regression model, a lower hemoglobin level, a lower left ventricular ejection fraction, and the forced expiratory volume in 1 s (FEV1) were independently associated with higher mortality in the total COPD group (p < 0.05).
Conclusions:
Hemoglobin levels and left ventricular ejection fraction along with a lower FEV1 were identified as independent risk factors for mortality in COPD patients who underwent comprehensive cardiac evaluations, suggesting that multidisciplinary approaches are required in the care of COPD.
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