Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

COPD in HF Patients & Risk of Hospitalization

JAMA Netw Open; 2018 Dec 14; Lawson, et al

In patients with heart failure (HF), increasing chronic obstructive pulmonary disease (COPD) severity is associated with increasing risk of mortality and hospitalization, a recent study found. In this population-based study, researchers sought to determine the associations between COPD medication intensity or state of airflow limitation and the risk of hospitalization or death in patients with HF. Participants were aged ≥40 years with a new diagnosis of HF in their family practice clinical record. In patients with HF, those with COPD were compared to those without it. The primary outcome was first all-cause admission or all-cause death. Among the findings:

  • There were 50,114 patients with new HF (median age 79 years) during the study period.
  • COPD increased the risk of hospital admission and death by > one-third, but increased risk was specific to patients receiving the most intense COPD medication regimens.
  • Availability of spirometry data was limited but showed the increasing airflow limitation was associated with increased risk of mortality.


Lawson CA, Mamas MA, Jones PW, et al. Association of medication intensity and stages of airflow limitation with the risk of hospitalization or death in patients with heart failure and chronic obstructive pulmonary disease. JAMA Netw Open. 2018;1(8):e185489. doi:10.1001/jamanetworkopen.2018.5489.

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