Impacto pronóstico de la enfermedad pulmonar obstructiva crónica y el asma bronquial en pacientes con insuficiencia cardiaca

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola Pub Date : 2024-03-01 DOI:10.1016/j.rce.2024.01.003

E. Barge-Caballero , J. Sieira-Hermida , G. Barge-Caballero , D. Couto-Mallón , M.J. Paniagua-Martín , D. Enríquez-Vázquez , P.J. Marcos-Rodríguez , J. Rodríguez-Capitán , J.M. Vázquez-Rodríguez , M.G. Crespo-Leiro

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引用次数: 0

Abstract

Purpose

To analyze the impact of chronic obstructive pulmonary disease (COPD) and bronchial asthma on therapeutic management and prognosis of patients with heart failure (HF).

Methods

Analysis of the information collected in a clinical registry of patients referred to a specialized HF unit from January-2010 to June-2012. Clinical profile, treatment and prognosis of patients was evaluated, according to the presence of COPD or asthma. Survival analyses were conducted by means of Kaplan-Meier and Cox's methods. Median follow-up was 1493 days.

Results

We studied 2577 patients, of which 251 (9.7%) presented COPD and 96 (3.7%) bronchial asthma. Significant differences among study groups were observed regarding to the prescription of beta-blockers (COPD = 89.6%; asthma = 87.5%; no bronchopathy = 94.1%; P = .002) and SGLT2 inhibitors (COPD = 35.1%; asthma = 50%; no bronchopathy = 38.3%; P = .036). Also, patients with bronchial disease received less frequently a defibrillator (COPD = 20.3%; asthma = 20.8%; no broncopathy = 29%; P = .004).

COPD was independently associated with increased risk of all-cause mortality (HR = 1.64; 95% CI: 1.33-2.02), all-cause death or HF admission (HR = 1.47; 95% CI: 1.22-1.76) and cardiovascular death or heart transplantation (HR = 1.39; 95% CI: 1.08-1.79) as compared with patients with no bronchopathy. Bronchial asthma was not significantly associated with increased risk of adverse outcomes.

Conclusions

COPD, but not asthma, is an adverse independent prognostic factor in patients with HF.

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慢性阻塞性肺病和支气管哮喘对心力衰竭患者预后的影响

目的分析慢性阻塞性肺病（COPD）和支气管哮喘对心力衰竭（HF）患者的治疗管理和预后的影响。方法分析 2010 年 1 月至 2012 年 6 月期间转诊至 HF 专科病房的患者的临床登记信息。根据是否患有慢性阻塞性肺病或哮喘，对患者的临床概况、治疗和预后进行了评估。采用卡普兰-梅耶法和考克斯法进行生存分析。结果我们对 2577 名患者进行了研究，其中 251 人（9.7%）患有慢性阻塞性肺病，96 人（3.7%）患有支气管哮喘。研究组之间在使用β-受体阻滞剂（慢性阻塞性肺病 = 89.6%；哮喘 = 87.5%；无支气管病 = 94.1%；P = .002）和 SGLT2 抑制剂（慢性阻塞性肺病 = 35.1%；哮喘 = 50%；无支气管病 = 38.3%；P = .036）方面存在显著差异。此外，支气管疾病患者接受除颤器的频率较低（慢性阻塞性肺病 = 20.3%；哮喘 = 20.8%；无支气管病变 = 29%；P = .004）。慢性阻塞性肺病与全因死亡风险增加独立相关（HR = 1.与无支气管病变患者相比，慢性阻塞性肺病与全因死亡风险增加（HR = 1.64；95% CI：1.33-2.02）、全因死亡或入住高频病房风险增加（HR = 1.47；95% CI：1.22-1.76）以及心血管死亡或心脏移植风险增加（HR = 1.39；95% CI：1.08-1.79）独立相关。结论慢性阻塞性肺病（而非哮喘）是心房颤动患者的一个独立不良预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista clinica espanola 医学-医学：内科

CiteScore

4.40

自引率

6.90%

发文量

审稿时长

28 days

期刊介绍： Revista Clínica Española published its first issue in 1940 and is the body of expression of the Spanish Society of Internal Medicine (SEMI). The journal fully endorses the goals of updating knowledge and facilitating the acquisition of key developments in internal medicine applied to clinical practice. Revista Clínica Española is subject to a thorough double blind review of the received articles written in Spanish or English. Nine issues are published each year, including mostly originals, reviews and consensus documents.