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

Key Points Question Who are the highest risk heart failure (HF) patients with chronic obstructive pulmonary disease (COPD)? Findings In this nested case-control study of more than 50 000 UK patients with HF, COPD increased the risk of hospital admission and death by more than a third, but increased risk was specific to patients receiving the most intense COPD medication regimens: triple inhaler therapy, prescribed oral corticosteroids, or oxygen therapy. Spirometry recording was limited in the community setting was restricted to more severe patients with HF and COPD, and for these patients the risk of mortality significantly increased alongside increasing airway limitation. Meaning Optimal care of patients with HF and COPD requires accurate diagnosis and targeting of severe COPD markers to prevent admissions and death.