Disease Clinical Trial
Official title:
COPD in Patients Hospitalized for Acute Decompensated Heart Failure.
The presence of chronic obstructive pulmonary disease (COPD) would confer increased in-hospital mortality and length of hospital stay in patients with acute decompensated heart failure Assess the (1) prevalence of COPD in patients who are hospitalized for acute decompensated heart failure and (2) the association between COPD and in-hospital mortality or length of stay in this cohort.
Background:
The prevalence of mild to moderate COPD is ~5%-10% with one-year mortality around 3% while
heart failure affects is1%-3% with one year mortality 5-7% in the community. The mortality of
COPD and heart failure dramatically increase following hospitalization.
Heart failure and COPD are independent predictors of increased morbidity and mortality. COPD
and heart failure frequently co-exist in an individual patient through the shared risk
factors. The prevalence of COPD in heart failure patient-population and vice verse varies
widely according to patient-selection and age of the population. Estimates suggest that COPD
is present in 10-40% of the patients with heart failure. Conversely, unrecognized heart
failure is identified in approximately 20% of the patient with COPD. The impact of COPD on
clinical outcome in patients with acute decompensated heart failure is unclear.
Methods:
This is an observational cohort study. Per national registry, acute heart failure is defined
as either new onset heart failure or decompensation of chronic established heart failure with
symptoms sufficient to warrant hospitalization.
The data related to the following variables would be collected:
age, gender, severity of heart failure (mild, moderate, and severe prior to admission),
presence of dyspnea, peripheral edema, crackles, systolic and diastolic blood pressure (on
admission and on discharge), heart rate (on admission and on discharge), oxygen saturation
(on admission and discharge), blood urea nitrogen (on admission and discharge), serum
creatinine (on admission and discharge), serum sodium (on admission and discharge),
hemoglobin (on admission and discharge), red cell distribution width (on admission and
discharge), electrocardiographic intervals (on admission and discharge), comorbidities
(coronary artery disease, chronic kidney disease, atrial fibrillation, diabetes,
hypertension, dyslipidemia, peripheral artery disease, COPD/asthma, left ventricular ejection
fraction >40%. Medication use: angiotensin converting enzyme inhibitors, angiotensin receptor
blockers, aspirin, metoprolol tartrate, metoprolol succinate, carvedilol, atenolol,
amlodipine, Cardizem, clopidogrel, digoxin, diuretics, statins, nitrates, warfarin,
non-steroidal anti-inflammatory drugs, hydralazine.
End-points:
1) All cause in-hospital death and 2) length of hospital stay between heart failure patients
with COPD and those with no COPD.
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