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Chronic obstructive pulmonary disease and β‐blocker treatment in Asian patients with heart failure

机译：亚洲心力衰竭患者的慢性阻塞性肺疾病和β受体阻滞剂的治疗

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Aims Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are increasingly frequent in Asia and commonly coexist in patients. However, the prevalence of COPD among Asian patients with HF and its impact on HF treatment are unclear. Methods and results We compared clinical characteristics and treatment approaches between patients with or without a history of COPD, before and after 1:2 propensity matching (for age, sex, geographical region, income level, and ethnic group) in 5232 prospectively recruited patients with HF and reduced ejection fraction (HFrEF, 40%) from 11 Asian regions (Northeast Asia: South Korea, Japan, Taiwan, Hong Kong, and China; South Asia: India; Southeast Asia: Thailand, Malaysia, Philippines, Indonesia, and Singapore). Among the 5232 patients with HFrEF, a history of COPD was present in 8.3% ( n ?=?434), with significant variation in geography (11.0% in Northeast Asia vs. 4.7% in South Asia), regional income level (9.7% in high income vs. 5.8% in low income), and ethnicity (17.0% in Filipinos vs. 5.2% in Indians) (all P ??0.05). Use of mineralocorticoid receptor antagonists and diuretics was similar between groups, while usage of all β‐blockers was lower in the COPD group than in the non‐COPD group in the overall (66.3% vs. 79.9%) and propensity‐matched cohorts (66.3% vs. 81.7%) (all P ??0.05). A striking exception was the Japanese cohort in which β‐blocker use was high in COPD and non‐COPD patients (95.2% vs. 91.2%). Conclusions The prevalence of COPD in HFrEF varied across Asia and was related to underuse of β‐blockers, except in Japan.
机译：目的在亚洲，慢性阻塞性肺疾病（COPD）和心力衰竭（HF）越来越多，并且通常并存于患者中。然而，目前尚不清楚亚洲HF患者中COPD的患病率及其对HF治疗的影响。方法和结果我们比较了5232名预期招募的患有COPD病史的患者（年龄，性别，地理区域，收入水平和种族）在1：2倾向匹配前后的临床特征和治疗方法。来自11个亚洲地区（东北亚：韩国，日本，台湾，香港和中国;南亚：印度;东南亚：泰国，马来西亚，菲律宾，印度尼西亚和印度）的HF和射血分数降低（HFrEF，<40％）新加坡）。在5232名HFrEF患者中，COPD病史的发生率为8.3％（n = 434），地理差异显着（东北亚为11.0％，南亚为4.7％），地区收入水平（9.7％）在高收入人群中，低收入人群为5.8％），在种族方面（菲律宾人为17.0％，印度人为5.2％）（所有P <0.05）。两组间盐皮质激素受体拮抗剂和利尿剂的使用相似，而总体上（6-6.3％vs. 79.9％）和倾向匹配的人群中，COPD组中所有β-受体阻滞剂的使用率均低于非COPD组。 ％对81.7％）（所有P≤0.05）。日本队列中一个明显的例外是，在COPD和非COPD患者中，β受体阻滞剂的使用率很高（95.2％比91.2％）。结论除日本外，HFrEF中COPD的患病率在亚洲各地有所不同，并且与β受体阻滞剂的使用不足有关。

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