Morbidity and mortality in a population of patients affected by heart failure and chronic obstructive pulmonary disease: an observational study
- PMID: 30651063
- PMCID: PMC6335816
- DOI: 10.1186/s12872-018-0986-y
Morbidity and mortality in a population of patients affected by heart failure and chronic obstructive pulmonary disease: an observational study
Abstract
Background: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) often coexist. Moreover, elderly patients suffering from HF have a higher incidence of COPD, which further complicates their clinical condition. Indacaterol/glycopirronium has shown benefits in the treatment of COPD, with few cardiologic adverse effects. We evaluated the safety and efficacy of this therapy in patients with history of HF.
Methods: We enrolled 56 patients with a history of HF (New York Heart Association [NYHA] classes II and III) and stable COPD. We evaluated blood samples, clinical assessment, echocardiograms and basal spirometry at baseline and after 6 months of therapy with indacaterol/glycopirronium. In addition, the number of re-hospitalizations during the treatment period was evaluated.
Results: The treatment was well tolerated. Brain natriuretic peptide (BNP) levels were significantly reduced compared with baseline (p < 0.001) after 6 months of treatment, and a higher percentage of patients improved their clinical status compared with baseline (p < 0.001). Minor changes were noted in the hemodynamic and metabolic parameters. Significant improvements in the echocardiographic parameters were noted in HF with reduced ejection fraction (HFrEF) patients. All respiratory parameters (forced expiratory volume in 1 s [FEV1], FEV1/forced vital capacity [FVC] ratio and COPD Assessment Test [CAT] scores) improved significantly (p < 0.001). No hospitalizations owing to HF or COPD exacerbation occurred. One patient died of respiratory failure.
Conclusion: Indacaterol/glycopirronium was well-tolerated and effective in the treatment of COPD in this cohort of patients with a history of HF. Further studies are needed to clarify whether this compound can have a direct role in improving overall cardiovascular function.
Keywords: Chronic obstructive pulmonary disease; Elderly; Heart failure; Indacaterol/glycopirronium.
Conflict of interest statement
Ethics approval and consent to participate
Yes. Informed, written consent was obtained from all participants. The study was evaluated by the ethical board of the S. Orsola-Malpighi University Hospital.
Consent for publication
Yes
Competing interests
The authors declare that they have no competing interests.
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
-
- Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017. Available from: http://goldcopd.org.
-
- Pavasini R, Tavazzi G, Biscaglia S, Guerra F, Pecoraro A, Zaraket F, et al. Amino terminal pro brain natriuretic peptide predicts all-cause mortality in patients with chronic obstructive pulmonary disease: systematic review and meta-analysis. Chron Respir Dis. 2017;14(2):117–116. doi: 10.1177/1479972316674393. - DOI - PMC - PubMed
-
- Kitzman DW, Gardin JM, Gottdiener JS, Arnold A, Boineau R, Aurigemma G, et al. Cardiovascular health study research group. Importance of heart failure with preserved systolic function in patients > or = 65 years of age. CHS research group. Cardiovascular health study. Am J Cardiol. 2001;87(4):413–419. doi: 10.1016/S0002-9149(00)01393-X. - DOI - PubMed
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