Independent risk factors for mortality in patients with chronic obstructive pulmonary disease who undergo comprehensive cardiac evaluations.
BACKGROUND
Cardiovascular disease is the most common cause of death in chronic obstructive pulmonary disease (COPD). However, the impact of cardiovascular comorbidities on the prognosis of COPD is not well known.


OBJECTIVE
This study was performed to investigate the effects of cardiovascular comorbidities on the prognosis of COPD.


METHODS
We enlisted 229 patients with COPD who underwent comprehensive cardiac evaluations including coronary angiography and echocardiography at Ajou University Hospital between January 2000 and December 2012. Survival analyses were performed in this retrospective cohort.


RESULTS
Kaplan-Meier analyses showed that COPD patients without left heart failure (mean survival = 12.5 ± 0.7 years) survived longer than COPD patients with left heart failure (mean survival = 6.7 ± 1.4 years; p = 0.003), and the survival period of nonanemic COPD patients (mean survival = 13.8 ± 0.8 years) was longer than that of anemic COPD patients (mean survival = 8.3 ± 0.8 years; p < 0.001). The survival period in COPD with coronary artery disease (CAD; mean survival = 11.37 ± 0.64 years) was not different from that in COPD without CAD (mean survival = 11.98 ± 0.98 years; p = 0.703). According to a multivariate Cox regression model, a lower hemoglobin level, a lower left ventricular ejection fraction, and the forced expiratory volume in 1 s (FEV1) were independently associated with higher mortality in the total COPD group (p < 0.05).


CONCLUSIONS
Hemoglobin levels and left ventricular ejection fraction along with a lower FEV1 were identified as independent risk factors for mortality in COPD patients who underwent comprehensive cardiac evaluations, suggesting that multidisciplinary approaches are required in the care of COPD.
Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
Young-Hwan
YH
Ahn
Keu Sung
KS
Lee
Joo Hun
JH
Park
Jin-Hee
JH
Jung
Miyeon
M
Lee
Yun-Jung
YJ
Jung
Wou Young
WY
Chung
Seungsoo
S
Sheen
Kwang Joo
KJ
Park
Dae Jung
DJ
Kim
Dae Ryoung
DR
Kang
Jeong-Dong
JD
Lee
Soojee
S
Yoon
Xiong Jie
XJ
Jin
Hyoung-Mo
HM
Yang
Hong-Seok
HS
Lim
Jin Sun
JS
Park
Joon-Han
JH
Shin
Seung-Jea
SJ
Tahk
D000368:Aged; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D017023:Coronary Angiography / Q000379:methods; D015150:Echocardiography, Doppler; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D056910:Republic of Korea; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis