Chronic Obstructive Pulmonary Disease on Clinical Outcomes of Left Ventricular Assist Device Patients

Abstract

<h3>Purpose</h3> Chronic obstructive pulmonary disease (COPD) is commonly associated with heart failure due to sharing a common pathogenic mechanism. We aimed to evaluate the prognostic impact of concomitant COPD at the time of left ventricular assist device (LVAD) implantation. <h3>Methods</h3> We retrospectively analyzed 210 patients receiving LVAD implantation at a large tertiary academic center in the United States between January 2010 and April 2020. COPD was diagnosed by pre-implant pulmonary function tests according to American College of Chest Physicians guidelines. Univariable Cox proportional hazards regression was used to study overall survival as well as freedom from readmission between the two cohorts. <h3>Results</h3> There were no significant differences in clinical characteristics between the COPD (n=46) and control group (n=164). No difference in survival was observed between the two groups at 1 year (HR, 0.47; 95% CI, 0.10-2.13; P=0.329) and 3 years (HR, 0.84; 95% CI, 0.38-1.88; P=0.892). Freedom from readmission approached significance between the two groups at 1 year (P=0.054) and patients with COPD were more likely to be readmitted by 3 years (P=0.019). <h3>Conclusion</h3> COPD is not associated with worse survival in LVAD patients but is associated with poorer freedom from readmission. Although knowledge about the prevalence of concomitant COPD in heart failure patients and vice versa is scarce, their combined presence is rather common. In view of diagnostic and therapeutic implications, attention should be paid to the concurrent presence of both syndromes in clinical practice and research.