scholarly journals Association of asthma–chronic obstructive pulmonary disease overlap syndrome with coronary artery disease, cardiac dysrhythmia and heart failure: a population-based retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017657 ◽  
Author(s):  
Jun-Jun Yeh ◽  
Yu-Feng Wei ◽  
Cheng-Li Lin ◽  
Wu-Huei Hsu
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Beta Blockers ◽  
Overlap Syndrome ◽  
Chronic Obstructive ◽  
Cardiac Dysrhythmia ◽  
Obstructive Pulmonary Disease ◽  
Artery Disease ◽  
The Relationship

ObjectivesPatients with asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) and cardiovascular diseases (CVDs) share common risk factors. However, the association between ACOS and the incidence of CVDs has not been reported. This study investigated the relationship between CVDs and ACOS in the general population.SettingData were obtained from Taiwan’s National Health Insurance Research Database for the period 2000 to 2010.ParticipantsThe ACOS cohort comprised patients (n=5814) who had received a diagnosis of asthma and COPD. The non-ACOS cohort comprised patients who had not received a diagnosis of asthma or COPD and were matched to the ACOS cohort (2:1) by age, sex and index date (n=11 625).Primary and secondary outcome measuresThe cumulative incidence of CVDs—coronary artery disease (CAD), cardiac dysrhythmia (CD) and heart failure (HF)—was calculated. Cox proportional regression analysis was employed to examine the relationship between ACOS and CVDs.ResultsAfter adjustment for multiple confounding factors—age, sex, comorbidities and medications—patients with ACOS were associated with a significantly higher risk of CVDs; the adjusted HRs (aHRs; 95% CI) for CAD, CD and HF were 1.62 (1.50 to 1.76), 1.44 (1.30 to 1.61) and 1.94 (1.73 to 2.19), respectively, whereas those of beta-blockers treatment for CAD, CD and HF were 1.19 (0.92 to 1.53), 0.90 (0.56 to 1.45) and 0.82 (0.49 to 1.38). The aHR of atenolol treatment for CD was 1.72 (1.01 to 2.93). The aHRs (95% CIs) of ACOS without acute exacerbation of COPD (AE-COPD) for CAD, CD and HF were 1.85 (1.70 to 2.01), 1.57 (1.40 to 1.77) and 2.07 (1.82 to 2.35), respectively.ConclusionACOS was associated with higher CVD risk, even without the presence of previous comorbidities or AE-COPD. No significant differences in CVD events were observed in the ACOS cohort using beta-blockers, except for those using atenolol for treating CD.

Beta Blockers and Chronic Obstructive Pulmonary Disease (COPD): Sum of Evidence

2020 ◽  
Vol 16 ◽  
Author(s):  
Katerina Baou ◽  
Vasiliki Katsi ◽  
Thomas Makris ◽  
Dimitris Tousoulis
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Pulmonary Disease ◽  
Cardiac Arrhythmias ◽  
Beta Blockers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Artery Disease

Abstract:: Approximately, half a century has passed since the discovery of beta blockers. Then, their prime therapeutic purpose was to treat angina and cardiac arrhythmias, nowadays, beta blockers’ usage and effectiveness is extended to treat other cardiovascular diseases, such as hypertension, congestive heart failure, and coronary artery disease. Safety concerns were raised about beta blockers and their use for chronic obstructive pulmonary disease (COPD) patients with concurrent cardiovascular disease. After a thorough research of the literature, this review summarizes the evidence proving that beta blockers not only might be well tolerated in COPD patients, but they might also have a beneficial effect in this group of patients.

Additional Topics: Neuraxial and Anticoagulation

2018 ◽  
pp. 261-266
Author(s):  
Ruchir Gupta
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Congestive Heart Failure ◽  
Coronary Artery ◽  
Postoperative Pain ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Post Dural Puncture Headache ◽  
Artery Disease

In this chapter several topics related to neuraxial anesthesia and anticoagulation are discussed. Subtopics include use of neuraxial technique in patients with coronary artery disease, congestive heart failure, or chronic obstructive pulmonary disease. Use of heparin and patient-controlled epidural analgesia is also discussed. The mechanism of action for warfarin (Coumadin) is discussed, as are ways of reversing its effects. Also discussed is whether to use an epidural in a patient with HELLP syndrome. Treatments for patients with post-dural puncture headache (PDHD) are presented. Placement of an epidural catheter for postoperative pain is discussed, and instructions for performing spinal technique are given. Each scenario is presented as a short, three- to four-question additional topic.

scholarly journals ’Who Cares?' The experiences of caregivers of adults living with heart failure, chronic obstructive pulmonary disease and coronary artery disease: a mixed methods systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020927 ◽  
Author(s):  
Miriam Catherine Noonan ◽  
Jennifer Wingham ◽  
Rod S Taylor
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery Disease ◽  
Mixed Methods ◽  
Coronary Artery ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Artery Disease

ObjectiveTo assess the experiences of unpaid caregivers providing care to people with heart failure (HF) or chronic obstructive pulmonary disease (COPD) or coronary artery disease (CAD).DesignMixed methods systematic review including qualitative and quantitative studies.Data sourcesDatabases searched: Medline Ebsco, PsycInfo, CINAHL Plus with Full Text, Embase, Web of Science, Ethos: The British Library and ProQuest. Grey literature identified using: Global Dissertations and Theses and Applied Sciences Index and hand searches and citation checking of included references. Search time frame: 1 January 1990 to 30 August 2017.Eligibility criteria for selecting studiesInclusion was limited to English language studies in unpaid adult caregivers (>18 years), providing care for patients with HF, COPD or CAD. Studies that considered caregivers for any other diagnoses and studies undertaken in low-income and middle-income countries were excluded. Quality assessment of included studies was conducted by two authors.Data analysis/synthesisA results-based convergent synthesis was conducted.ResultsSearches returned 8026 titles and abstracts. 54 studies—21 qualitative, 32 quantitative and 1 mixed method were included. This totalled 26 453 caregivers who were primarily female (63%), with median age of 62 years. Narrative synthesis yielded six concepts related to caregiver experience: (1) mental health, (2) caregiver role, (3) lifestyle change, (4) support for caregivers, (5) knowledge and (6) relationships. There was a discordance between paradigms regarding emerging concepts. Four concepts emerged from qualitative papers which were not present in quantitative papers: (1) expert by experience, (2) vigilance, (3) shared care and (4) time.ConclusionCaregiving is life altering and complex with significant health implications. Health professionals should support caregivers who in turn can facilitate the recipient to manage their long-term condition. Further longitudinal research exploring the evolution of caregiver experiences over time of patients with chronic cardiopulmonary conditions is required.Trial registration numberCRD42016053412

Abstract 15693: Comorbidities in Heart Failure: A Population-Based Case-control Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Alanna M Chamberlain ◽  
Cynthia M Boyd ◽  
Sheila M Manemann ◽  
Shannon M Dunlay ◽  
Yariv Gerber ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chronic Conditions ◽  
Population Based ◽  
Chronic Obstructive ◽  
Diagnostic Code ◽  
Obstructive Pulmonary Disease ◽  
Comorbidity Burden ◽  
Artery Disease

Background: Whether age alone explains the comorbidity burden in heart failure (HF) is unclear. In particular, differences in the burden of co-morbid conditions in HF patients compared to population controls has not been well documented. Methods: The prevalence of 17 chronic conditions defined by the US Department of Health and Human Services were obtained in 1746 incident HF patients from 2000-2010 and controls matched 1:1 on sex and age from Olmsted County, MN. Conditions were ascertained requiring 2 occurrences of a diagnostic code. Logistic regression determined associations of each condition with HF. Results: Among the 1746 matched pairs (mean age 76.2 years, 43.5% men), the prevalence was higher in HF cases for all conditions (p<0.05) except dementia and osteoporosis. After adjusting for all conditions, hypertension, coronary artery disease, arrhythmia, asthma, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, hepatitis, and substance abuse were significantly more common in HF (figure). More than a 2-fold increased odds of hepatitis, arrhythmia, and coronary artery disease was observed among HF cases. Arrhythmia (34.2%), hypertension (31.1%), and coronary artery disease (27.8%) had the largest attributable risk of HF; for example, assuming a causal relationship, if arrhythmias were eliminated, 34% of HF would be avoided. Conclusions: Compared to age- and sex-matched controls, HF patients have a higher prevalence of many chronic conditions, indicating the excess comorbidity in HF is not due to age alone. Some cardiovascular conditions, including arrhythmia, coronary artery disease, and hypertension were more common in HF. Of the non-cardiovascular conditions, hepatitis had the strongest association with HF and was an unanticipated finding that deserves additional investigation. It is important to understand comorbidities as they play a key role in the excess mortality and healthcare utilization experienced by HF patients.

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