Abstract
Background: Comorbid heart failure (HF) is common in patients with COPD (2.6 times greater odds vs. non-COPD) and may result in different disease management. Objective: To examine associations between COPD and HF with regard to disease burden and factors affecting treatment adequacy. Methods: This multiphase study used anonymised, longitudinal data from two large UK health care databases to identify patients ≥40 years old with COPD, HF, or both COPD+HF. Other chronic respiratory diagnoses were exclusions. Cohorts were matched using direct matching methods. Results: In matched cohorts of 4831 patients, the MRC dyspnoea score in COPD+HF vs. COPD cohorts was 4 or 5 for 19% vs. 11% of patients, respectively (p<0.001). Patients with HF and new COPD were as likely to receive adequate COPD therapy (long-acting bronchodilators) as those with only COPD (adjusted hazard ratio 1.04; 95% CI 0.98–1.11). Patients with COPD and new HF (matched cohorts, n=5877) were less likely to receive adequate HF therapy (β-blockers) than those with only HF (36% vs. 58%; p<0.001). Of those with pre-existing HF, women, current smokers, non-obese patients, and those with poor recording of disease severity were less likely to be adequately treated for new COPD (Table). Conclusions: Patients with COPD+HF are more breathless than those with only COPD, and patients with comorbid COPD and HF often receive suboptimal COPD or HF treatment.
Published Version
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