SESSION TITLE: Heart Failure Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM
PURPOSE: COPD and cardiovascular disease share similar risk factors. Recognizing ADHF in the presence of AECOPD is complicated by similarities in symptoms and physical findings. BNP has been studied to be used as a detector for ADHF in AECOPD but it is still controversial because many conditions encountered in COPD ie. pulmonary hypertension and right ventricular stress have been shown to contribute to the increase of BNP. We sought to examine other risk factors and effect of ADHF on AECOPD.
METHODS: This study is a retrospective review of 136 patients hospitalized for AECOPD from January 1, 2011 to December 31, 2011. The demographic data, clinical manifestation, laboratory findings, and treatment were collected from medical record. The length of hospital stay (LOS) and all-cause mortality (MR) were compared between AECOPD group and ADHF superimposed AECOPD group.
RESULTS: From 136 patients (mean 69.7±11.7 years old, 47.1 % male), 22 patients were diagnosed with coexistent AECOPD and ADHF (16.2%), whereas 114 patients were in AECOPD group. The factors that were found to be associated with coexistent ADHF and AECOPD were hypertension (95.5 % vs 73.7 %, p = 0.03), hyperlipidemia (63.6%vs33.3%,p=0.01), diabetes (59.1%vs32.5%,p=0.02), and coronary artery disease (59.1%vs23.7%,p<0.01), peripheral edema (50%vs13.2%,p<0.01), and BNP level (464vs122,p<0.01). In binary logistic regression analysis, elevated BNP (OR=10.7;95%CI:2.5-40.7,P<0.01) and peripheral edema (OR=6.4;95%CI:1.5-20.8,P=0.01) were independent variables associated with coexisting of ADHF in AECOPD. LOS was 4.6 days and 3.4 days (p=0.20) in coexistent AECOPD and ADHF group and AECOPD group respectively. The 1-year MR are 27.3% and 24.6% (p=0.78) between 2 groups.
CONCLUSIONS: Coexistence of ADHF and AECOPD is not uncommon. From our study, the incidence was 16.2%. The factors significantly associated with concomitant conditions are BNP level and peripheral edema. The outcomes, in term of LOS and MR, in both groups are comparable.
CLINICAL IMPLICATIONS: BNP can be used as an indentifier of patients with COPD exarcerbation who also have concomitant acute decompensated heart failure.
DISCLOSURE: The following authors have nothing to disclose: Prangthip Charoenpong, Clifton Clarke
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