Impact of chronic obstructive lung disease in the occurrence of heart failure after acute coronary syndrome
L Sousa Azevedo, I Martins Moreira, I Nobrega Fernandes, P Sousa Mateus, S Leao, I MoreiraAbstract
Introduction
Chronic obstructive pulmonary disease (COPD) and heart failure (HF) share multiple risk factors, and their coexistence is associated with increased morbidity and mortality. In patients with acute coronary syndrome (ACS), the presence of COPD may further increase the risk of developing HF.
Objective
To evaluate how COPD influences the risk of heart failure in ACS patients.
Methods
This retrospective observational study included patients admitted to our center with ACS between October 2010 and July 2025, all of whom were recorded in a national registry. Individuals with a previous diagnosis of heart failure were excluded. The cohort was divided into two groups regarding their history of COPD. Differences between groups were assessed using the chi-square test for categorical variables and median-comparison tests for continuous variables. The impact of COPD on the occurrence of heart failure was evaluated using binary logistic regression adjusted for potential confounders, using as outcome the occurrence of de novo heart failure during hospital stay. For the regression analysis, non-smokers and former smokers were combined into a single category, and unstable angina served as the reference category for ACS type.
Results
A total of 1,392 patients were included, of whom 1015 (72.9%) were male, with a median age of 67 years. Previous COPD was known in 65 (4.7%) patients. During hospitalization, 253 patients (17.7%) developed heart failure. Significant differences between groups were observed for gender (p=0.03), age (p=0.008), smoking status (p<0.001), arterial hypertension (p<0.001), diabetes mellitus (p=0.002), and for the occurrence of heart failure during hospitalization (p<0.001In the multivariable logistic regression analysis adjusted for confounders, we verified that COPD (OR = 2.067; is an independent predictor for heart failure occurrence in our population.
Conclusions
In this study, chronic obstructive lung disease was associated with an increased likelihood of developing heart failure during hospitalization for ACS, that may be due to the multiple comorbidities associated with this disease, such as chronic hipoxemia. As such these findings suggest that these patients need a closer surveillance to prevent adverse outcomes.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.