Chronic Obstructive Pulmonary Disease in Heart Failure with Reduced Ejection Fraction: Prevalence, Prognostic, and Association of Triple Inhaled Therapy
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: The coexistence of heart failure with reduced ejection fraction (HFrEF) and chronic obstructive pulmonary disease (COPD) is a common health problem that complicates therapeutic management and worsens prognosis. Our aim was to analyse the association between COPD and HF treatment optimization, long-term clinical outcomes, mortality, and HF readmissions. Methods: A retrospective, observational study comparing two cohorts: HFrEF with COPD versus HFrEF without COPD. Beta-blocker (BB) and ivabradine dose optimization were assessed in both groups, and inhaled treatment was assessed in patients with COPD. Clinical outcomes during follow-up were analyzed using Kaplan–Meier methods and Cox proportional hazards regression. Results: 375 patients were included, of whom 71 had COPD (18.9%). No significant differences were observed between groups in BB or ivabradine dose optimization. After 60 months of follow-up, patients with COPD had higher rates of all-cause mortality (40.8% vs. 25.6%; p = 0.014), HF-related mortality (33.8% vs. 18.4%; p = 0.006), and HF readmission (50.7% vs. 35.2%; p = 0.014). COPD remained significantly associated with adverse clinical outcomes in multivariable Cox regression analysis. Among patients with COPD, dual inhaled therapy was the most common regimen (54.9%), followed by triple inhaled therapy (32.4%). Conclusions: In our cohort of patients with HFrEF, concomitant COPD was associated with higher mortality and HF readmission rates despite similar BB and ivabradine dose optimization between groups. These findings highlight the importance of COPD in the clinical management of patients with HFrEF, although the observational design of the study precludes causal conclusions. Further studies are warranted to clarify the relationship between COPD, HF outcomes, and treatment patterns.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm15218439
Authors: Nerea Aguayo-Caño, Jesus Alberto Torres Zamudio, Jorge Perea Armijo, Juan Diego Martin Diaz, Nouha Yacub Briceño, Manuel Cabello Terron, Enrique Enrile Sanchez, Álvaro Roldán-Guerra, Rafael González Manzanares, Manuel Crespin Crespin, Martín Ruiz-Ortiz, Dolores Mesa Rubio, Manuel Pan, Manuel Anguita-Sánchez, Juan Carlos Castillo Dominguez, Jose López Aguilera
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W7152024222