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Occurrence and impact of chronic obstructive pulmonary disease in elderly patients with stable heart failure


  • Conflict of interest statement: L.M.F. received payment for consultancy from: Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline Beech, Merck Sharp & Dhome, Novartis, Nycomed, Pearl Therapeutics, SigmaTau, Sterna, Peer Voice Europe, Pearl Therapeutic, OM Pharma Sa, TEVA; payment for lectures, Advisory Boards or Travel Expenses Reimbursements from: AstraZeneca, Dey Pharma, Novartis, Schering Plough, SigmaTau, Roche, German Aerospace Center, Mundipharma Int., Genetech Inc, Elevation Pharmaceutical, Ferrer Group; his institution received grants from Boehringer Ingelheim, ScheringPlough, Pfizer, Nycomed, Menarini Industrie Farmaceutiche, Chiesi Farmaceutici, GlaxoSmithKline, Merck Sharp & Dhome, Roche, AstraZeneca, Novartis, SigmaTau, Italian Ministry for University and Research, Italian Ministry of Health.

Piera Boschetto, Dipartimento di Medicina Clinica e Sperimentale, Sezione di Igiene e Medicina del Lavoro, Via Fossato di Mortara 64/b, 44100 Ferrara, Italy. Email:


Background and objective:  The coexistence of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) increases with age. The occurrence, prognosis and therapeutic implications of concurrent COPD in elderly patients with CHF were investigated.

Methods:  One hundred and eighteen consecutive patients, ≥65 years old with ≥10 pack/years of smoking and with a verified diagnosis of CHF in stable condition, were enrolled. They were followed for a mean of 1029 (range 758–1064) days. All patients had spirometry and the diagnosis and classification of COPD were made according to Global Initiative for Chronic Obstructive Lung Disease guidelines.

Results:  The mean occurrence of COPD was 30% (90% confidence interval: 24–37%). At baseline in patients with CHF and COPD, there was a shorter 6-min walk distance, lower arterial oxygen tension, glomerular filtration rate and higher N-terminal pro-B-type natriuretic peptide (all P < 0.05). The prescription of CHF therapies, including β-blockers, was similar in the two groups. After follow up, the presence of COPD in patients with CHF did not appear to influence survival.

Conclusions:  COPD is relatively frequent in elderly patients with CHF. COPD did not alter survival.