title: Chronic obstructive pulmonary disease and long-term mortality in elderly subjects with chronic heart failure.
abstract: BACKGROUND
  Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are associated with high rates of mortality in elderly subjects. Concurrent CHF and COPD frequently occur, especially in with advancing age. This study examines long-term mortality in community-dwelling elderly subjects affected by CHF alone, COPD alone, and coexistent CHF and COPD.
  
  
  METHODS
  The study evaluated 12-years mortality in 1288 subjects stratified for the presence or absence of CHF or COPD alone, and for coexistence of CHF and COPD.
  
  
  RESULTS
  Mortality, at 12 year follow-up, was 46.7% overall, 68.6% in the presence of CHF alone (p < 0.001), 56.9% in the presence of COPD alone (p < 0.01); mortality was 86.2% where CHF and COPD coexisted (p < 0.001) and was significantly higher than in CHF or COPD alone (p < 0.05). Multivariate analysis indicates that CHF (Hazard risk = 1.67, 95% confidence interval 1.15-3.27, p < 0.031) and COPD (Hazard risk = 1.27, 95% confidence interval = 1.08-1.85, p < 0.042) were predictive of long-term mortality. When CHF and COPD simultaneously occurred, the risk dramatically increased up to 3.73 (95% confidence interval = 1.19-6.93, p < 0.001).
  
  
  CONCLUSIONS
  Long-term follow-up showed higher mortality among elderly subjects affected by CHF or COPD. Simultaneous presence of CHF and COPD significantly increased the risk of death. Therefore, the presence of COPD in CHF patients should be considered a relevant factor in predicting high risk of mortality.
authors.affiliation: Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, 86100,, Campobasso, Italy. gianluca.testa@unimol.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Testa
authors.affiliation: Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.|IRCCS Salvatore Maugeri Foundation, Scientific Institute of Campoli/Telese, Benevento, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cacciatore
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bianco
authors.affiliation: Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.|IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: David
authors.initials: D
authors.lastname: Della-Morte
authors.affiliation: Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Mazzella
authors.affiliation: IRCCS Salvatore Maugeri Foundation, Scientific Institute of Veruno, Novara, Italy.
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Galizia
authors.affiliation: Division of Geriatrics, AON SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gargiulo
authors.affiliation: Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Curcio
authors.affiliation: Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Liguori
authors.affiliation: Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, 86100,, Campobasso, Italy.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Sabusco
authors.affiliation: IRCCS Salvatore Maugeri Foundation, Scientific Institute of Campoli/Telese, Benevento, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Rengo
authors.affiliation: Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonaduce
authors.affiliation: Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Abete
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*
keywords: Chronic heart failure; Chronic obstructive pulmonary disease; Elderly; Mortality