Comorbidities in elderly smokers with COPD or CHF

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Aim: To investigate the influence of comorbidities in patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF), we examined 2 groups of elderly(>65yrs) heavy smokers with COPD or CHF as primary diagnosis. Methods: We examined 143 patients with stable COPD according to GOLD guidelines and 96 patients with stable CHF according to NYHA guidelines. All patients underwent lung function test, echocardiography, and carotid ultrasound. Hemoglobin A1c(HbA1c), fasting insulin, metabolic syndrome were evaluated according to the IDF criteria. Results: Patients with COPD had mean age of 72 yrs(range 65-84;male 76%); 31 were GOLD I, 79 II, 30 III, 3 IV. Patients with CHF had mean age of 74 yrs(range 65-88;male 91%), 40 were NYHA I, 50 II, 6 III. Smoking habit was significantly heavier in COPD patients(mean p/y 50, range 20-160;23% current smokers) compared to CHF patients(mean p/y 30, range 20-101;16% current smokers)[p<0.001]. Higher level of Charlson index was significantly observed in CHF group vs COPD group(p<0.001). The commonest comorbidities associated to COPD and CHF were hypertension(77%), metabolic syndrome(74%), diabetes(21%), depression(10%), osteoporosis(6%). Among comorbidities, diabetes occurred most commonly in CHF patients(34%)[p<0.001] with higher levels of HbA1c(mean 6.4%) compared to COPD patients(mean 6%)[p<0.001]. Peripheral vascular disease was most often reported among CHF patients(66%) compared to COPD patients(47%)[p<0.001]. Conclusions: COPD and CHF are frequently associated to chronic comorbidities, mostly cardiovascular and metabolic. These comorbidities may have a different impact on the prognosis of patients with COPD or CHF. Funded by Ministry of Health, CFR, Chiesi Foundation.