Trends in Heart Failure Incidence in the UK COPD Population

Sarfaroj Khan 

May 06, 2020

Takeaway

  • The incidence of heart failure (HF) in the UK primary care chronic obstructive pulmonary disorder (COPD) population was steady in the last decade.

  • Patients with COPD and incident HF (COPD-iHF) experienced significantly higher mortality vs patients with COPD and without HF (COPD-no HF).

  • The mortality rates of patients with COPD-iHF have not improved over the last decade.

Why this matters

  • Findings suggest that HF remains under-diagnosed in patients with COPD and that, when recognised, maybe under-treated leading to poor survival.

  • Bespoke guidelines for the diagnosis and management of HF in the COPD population are needed to improve diagnosis and outcome.

Study design

  • This study calculated the annual incidence of HF in 95,987 HF-naïve patients with COPD using data from the UK Clinical Practice Research Datalink (CPRD) from 2006 to 2016.

  • Association between incident HF with short- and long-term mortality was also evaluated in this population.

  • Funding: The National Institute for Health Research (NIHR) Imperial Biomedical Research Centre.

Key results

  • The crude incidence of HF was steady in patients with COPD from 2006 to 2016 (1.18 per 100 person-years; 95% CI, 1.09-1.27).

  • In patients with COPD, incident HF was associated with a >3-fold increase in 1-year mortality and a 2-fold increase in 5- and 10-year mortality vs patients with COPD-no HF with no change based on year of HF diagnosis.

  • The effect of incident HF on the mortality of patients with COPD did not improve over time.

    • 2011 (1-year adjusted mortality rate ratio [aMRR], 1.26; 95% CI, 0.83-1.90 and 5-year aMRR, 1.26; 95% CI, 0.98-1.61),

    • 2015 (1-year aMRR, 1.63; 95% CI, 0.98-2.70).

Limitations

  • Validity of case definitions within electronic health care records.

 

Axson EL, Sundaram V, Bloom CI, Bottle A, Cowie MR, Quint JK. Temporal Trends in the Incidence of Heart Failure among Patients with COPD and Its Association with Mortality. Ann Am Thorac Soc. 2020 Apr 10 [Epub ahead of print]. doi: 10.1513/AnnalsATS.201911-820OC. PMID: 32275836  View abstract 

This clinical summary first appeared on Univadis from Medscape.

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