Abstract 16961: Time-dependent Markers of Chronic Obstructive Pulmonary Disease Severity and Change are Associated With Increased Risk of Mortality in the General Heart Failure Population: A National Study of 50,114 Patients From the United Kingdom

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Claire A Rushton ◽  
Lucy Riley ◽  
Duwarakan K Satchithananda ◽  
Peter W Jones ◽  
Umesh T Kadam
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Forced Expiration ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage ◽  
Risk Of Mortality ◽  
Increased Risk

Purpose: Heart failure (HF) carries poor prognosis which changes over time. Chronic obstructive pulmonary disease (COPD) is common in HF and increases risk of mortality but how COPD severity and change influences HF prognosis is unknown. We hypothesised that in the HF general population, comorbidity stratification by increasing severity and longitudinal change would be associated with increased mortality. Methods: We used a case-control study nested within the UK Clinical Practice Research Datalink database (12-year time-period to 2014), of newly diagnosed HF patients aged over 40 years. Using risk set sampling, four controls were matched to cases on calendar and follow-up time. Routinely collected clinical measures of severity and change for COPD were (i) forced expiration volume in 1 second (FEV 1 ) stages, defined by Global Initiatives for Chronic Obstructive Lung Disease (GOLD) guidelines and (ii) prescribed medications in two time-windows covering 1-year prior to the match date. Conditional logistic regression was used to estimate risk ratios (RR) for all-cause mortality adjusted for known confounders. Results: Of the 50,114 HF sample, 5,848 (11.7%) had COPD and of these 62% died during follow-up compared to 52% of patients without COPD. COPD comorbidity risk associated with mortality stratified by GOLD stages was as follows: stage 1; adjusted RR 1.73 (95% CI 1.50-1.99) to stage 4; 3.14 (2.65, 3.73). Estimates for COPD FEV 1 change compared to no COPD were: GOLD stage same or better; 2.15 (1.97, 2.34) and GOLD stage worse; 2.70 (2.30, 3.17). The mortality estimates for medications severity were: inhalers only 1.13 (1.07,1.19), oral steroids; 1.83 (1.69,1.97) and oxygen; 2.94 (2.47, 3.51). The estimates for medications change were: no new steroids or oxygen; 1.22, (1.16, 1.28), new steroids but not oxygen; 1.84, (1.67,1.28) and new on oxygen; 3.41, (2.71,4.29). Conclusions: COPD is an important and common comorbidity in HF. Our results show that worse COPD severity and recent change based on routinely collected clinical data was associated with increased mortality and provides key prognostic information for clinical assessment in practice.

scholarly journals Association of Anthropometric Indexes With Disease Severity in Male Patients With Chronic Obstructive Pulmonary Disease in Qazvin, Iran

2018 ◽  
Vol 12 (4) ◽  
pp. 1023-1028 ◽  
Author(s):  
Ramin Sami ◽  
Raheleh Sadegh ◽  
Neda Esmailzadehha ◽  
Sanaz Mortazian ◽  
Masoomeh Nazem ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Stage Iv ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage ◽  
Increased Risk ◽  
Anthropometric Indexes ◽  
Male Patients

Malnutrition is one of the most important factors that lead to lower quality of life in patients suffering from chronic obstructive pulmonary disease (COPD). There are several methods for assessing malnutrition including anthropometric indexes. The aim of this study was to determine the association of anthropometric indexes with disease severity in male patients with COPD in Qazvin, Iran. This cross-sectional study was conducted on 72 male patients with COPD in Qazvin, Iran, from May to December 2014. Spirometry was performed for all participants. Disease severity was determined using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline. Body mass index (BMI), mid-arm muscle circumference (MAMC), and triceps skinfold thickness (TSF) were measured. MAMC and TSF were categorized into three subgroups as <25th P, between 25th P and 75th P, and >75th P (Where P is the abbreviation for percentile.). Data were analyzed using ANOVA and logistic regression analysis. Mean age was 60.23 ± 11.39 years. Mean BMI was 23.23 ± 4.42 Kg/m2, mean MAMC was 28.34 ± 3.72 cm2, and mean TSF was 10.15 ± 6.03 mm. Mean BMI and MAMC in the GOLD stage IV were significantly lower than other stages. Of 72, 18.1% were underweight while 6.9% were obese. The GOLD stage IV was associated with 16 times increased risk of underweight and nine times increased risk of MAMC < 25th P. Disease severity was associated with BMI and MAMC as indexes of malnutrition in patients with COPD in the present study. The GOLD stage IV was associated with increased risk of underweight and low MAMC.

Relation between Chronic Obstructive Pulmonary Disease and Peripheral Arterial Disease among Construction Workers

2021 ◽  
Vol 15 (10) ◽  
pp. 3473-3475
Author(s):  
U. Sivakumar ◽  
Rinku Garg ◽  
Sunita Nighute
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Peripheral Arterial Disease ◽  
Pulmonary Disease ◽  
Arterial Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Risk Of Death ◽  
Increased Risk ◽  
Peripheral Arterial

Introduction: PAD was asymptomatic in a large proportion of COPD patients and was associated with more severe lung disease than in COPD subjects without PAD. Materials and Methods: This was a Cross-sectional study conducted at Department of Physiology, Santosh Medical College diagnosed with COPD using Spirometry was recruited for the study with a Sample size of 130 patients. Results: The characteristics of the population for follow-up (n=130) are presented in table 1. The mean Mean±SD was 51.73±6.1 years. The prevalence of never smokers was 21.5%, former smokers were 51.5% and current smokers were 26.9%. In total, 41 out of 130 individuals (31.5%) had PAD based on an ABI of less than 0.6. A statistically significant association was found between COPD and newly diagnosed PAD during follow-up. The association between COPD and incident PAD was stronger (adjusted OR 1.91, 95% CI 1.14–3.21). Stratified analysis by smoking status revealed that the overall association between COPD and newly developed PAD was driven by the ever smoker group. Conclusion: Subjects with COPD have a higher risk of developing PAD. People with both COPD and PAD have a substantially increased risk of death. Consequently, early detection of PAD and preventive actions in people with COPD should receive more attention in clinical respiratory care. Keywords: Peripheral Arterial Disease, Chronic Obstructive Pulmonary Disease, Ankle-brachial index.

Periodontitis Is Associated with Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 98 (5) ◽  
pp. 534-540 ◽  
Author(s):  
K. Takeuchi ◽  
K. Matsumoto ◽  
M. Furuta ◽  
S. Fukuyama ◽  
T. Takeshita ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Population Attributable Fraction ◽  
Community Dwelling ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
Severe Periodontitis ◽  
The Relationship

Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of <0.7 for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and by FEV1/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.

scholarly journals Chronic Obstructive Pulmonary Disease and Risk of Mortality in Patients with Venous Thromboembolism—The Tromsø Study

2019 ◽  
Vol 120 (03) ◽  
pp. 477-483
Author(s):  
Trond Børvik ◽  
Sigrid K. Brækkan ◽  
Line H. Evensen ◽  
Ellen E. Brodin ◽  
Vania M. Morelli ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Venous Thromboembolism ◽  
Pulmonary Disease ◽  
Physical Inactivity ◽  
Chronic Obstructive ◽  
Minor Effect ◽  
Obstructive Pulmonary Disease ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Increased Risk

Abstract Background Previous studies have shown increased mortality in venous thromboembolism (VTE) patients with chronic obstructive pulmonary disease (COPD), but it is unknown to what extent the association is influenced by the severity of COPD and physical inactivity. Objectives This article investigates whether COPD, and stages of COPD, influenced the risk of mortality after a first episode of VTE when physical inactivity was taken into account. Methods Patients with a first lifetime VTE (n = 256) were recruited among individuals who participated and performed spirometry in the fifth (2001–2002) and sixth (2007–2008) surveys of the Tromsø Study (n = 9577). All-cause mortality was registered up to December 31, 2015. Results There were 123 deaths during a median of 2.9 years of follow-up. The overall mortality rate was 11.9 (95% confidence interval [CI] 10.0–14.2) per 100 person-years. The risk of death was twofold higher in COPD patients compared with those with normal airflow (hazard ratio [HR] 2.00, 95% CI 1.30–3.08) after multivariable adjustment. The risk of death increased with the severity of COPD. VTE patients with COPD stage III/IV had a fivefold increased risk of death (HR 5.20, 95% CI 2.65–10.2) compared with those without COPD, and 50% of these patients died within 3.5 months after the incident VTE event. Adjustment for physical inactivity had minor effect on the risk estimates. Conclusion VTE patients with COPD had increased risk of death, particularly patients with severe COPD. The detrimental effect of COPD on mortality in VTE patients was apparently explained by factors other than physical inactivity among patients with COPD.

Abstract 11292: Impact of Chronic Obstructive Pulmonary Disease on Cardiovascular Function and Prognosis in Heart Failure Patients

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Takeshi Shimizu ◽  
Akiomi Yoshihisa ◽  
Mai Takiguchi ◽  
Minoru Nodera ◽  
Shunsuke Miura ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Troponin T ◽  
Stage Ii ◽  
Chronic Obstructive ◽  
Estimated Gfr ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage ◽  
All Cause Mortality

Background: Chronic obstructive pulmonary disease (COPD) often coexists with heart failure (HF), and is thought to have a critical association with mortality and morbidity in HF patients. However, the impact of COPD on cardiovascular function and the detailed all-cause mortality of HF remain unclear. Methods and Results: Consecutive 378 patients admitted for HF who underwent spirometry were divided into 3 groups: HF without COPD (Non-COPD group, n = 272), HF with mild COPD (GOLD I group, n = 82), and HF with moderate COPD (GOLD II group, n = 24). We compared echocardiographic findings, vascular function including flow mediated dilatation (FMD) and cardio-ankle vascular index and circulating levels of troponin T, BNP, CRP, and estimated GFR among the three groups. The GOLD II group, as compared to Non-COPD group, had 1) higher troponin T (0.030 vs. 0.020 ng/ml, P = 0.009), 2) greater cardio-ankle vascular index (8.99 vs. 8.29, P = 0.032), 3) similar levels of FMD, BNP, CRP, and estimated GFR, and 4) similar cardiac systolic and diastolic function of the right and left ventricle. In addition, rates of cardiac (P = 0.049), non-cardiac (P = 0.001), and all-cause mortality (P = 0.002) were higher in GOLD II group than in Non-COPD and GOLD I groups. Importantly, in the Cox proportional hazard analyses, the GOLD stage II was an independent predictor of cardiac (P = 0.038), non-cardiac (P = 0.036), and all-cause mortality (P = 0.015) in HF patients. Conclusions: HF patients with coexistent moderate COPD (GOLD stage II) have greater myocardial damage, greater arterial stiffness, and higher cardiac and non-cardiac mortality. Thus, taking appropriate management to control COPD may improve the prognosis of HF patients with COPD.

Midterm Results of Routine Bilateral Internal Thoracic Artery Grafting

2005 ◽  
Vol 6 (5) ◽  
pp. 348 ◽  
Author(s):  
A. Kramer ◽  
R. Mohr ◽  
O. Lev-Ran ◽  
R. Braunstein ◽  
D. Pevni ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Regression Analysis ◽  
Pulmonary Disease ◽  
Internal Thoracic Artery ◽  
Chronic Obstructive ◽  
Midterm Results ◽  
Obstructive Pulmonary Disease ◽  
Sternal Infection ◽  
Repeat Operation

Background: Skeletonized dissection of the internal thoracic artery (ITA) decreases the occurrence of sternal devascularization, thus decreasing the risk of postoperative sternal complications in patients undergoing bilateral ITA grafting. Methods: From April 1996 to July 1999, 1000 consecutive patients underwent bilateral skeletonized ITA grafting. Of the 770 male and 230 female patients, 420 were older than 70 years, and 312 had diabetes. Results: Operative mortality was 3.3%. Follow-up (4078 months) revealed 79 late deaths, and the Kaplan-Meier 6-year survival rate was 88%. Cox regression analysis revealed increased overall mortality (early and late) in patients with preoperative congestive heart failure (risk ratio [RR], 2.13; 95% confidence interval [CI], 1.31-3.45), in patients with peripheral vascular disease (RR, 5.52; 95% CI, 3.31-9.19), and in patients older than 70 years (RR, 2.18; 95% CI, 1.37-3.47). Early postoperative morbidity included sternal infection (2.2%), cerebrovascular accident (1.6%), and perioperative myocardial infarction (1%). Multiple regression analysis showed repeat operation (odds ratio [OR], 7.5; 95% CI, 1.77-31.6) and chronic obstructive pulmonary disease (OR, 3.6; 95% CI, 1.27-10.75) to be independent predictors of sternal infection. During follow-up, angina returned in 95 patients, 24 of whom required reintervention (20 cases of percutaneous balloon angioplasty and 4 reoperations). Postoperative coronary angiography performed in 87 patients revealed an ITA patency rate of 91%. Conclusions: Bilateral skeletonized ITA grafting is associated with satisfactory early and midterm results. We do not recommend the use of this surgical technique in patients with chronic obstructive pulmonary disease.

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