Evidence map›Paper›PMID 33927022›Full record

ArticleThorax2021

Relationship between heart failure and the risk of acute exacerbation of COPD.

Eleanor L Axson, Alex Bottle, Martin R Cowie, Jennifer K Quint

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Thorax, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
4.0field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  17. The Diagnosis and Treatment of COPD and Its Comorbidities.Deutsches Arzteblatt international · 2023
    Review
  18. Article
  19. Exploring Patterns of COPD Exacerbations and Comorbid Flare-Ups.International journal of chronic obstructive pulmonary disease · 2023
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Eleanor L AxsonNational Heart and Lung Institute, Imperial College London, London, UK.ORCID http://orcid.org/0000-0001-9494-2389
Alex BottleSchool of Public Health, Imperial College London, London, UK.
Martin R CowieNational Heart and Lung Institute, Imperial College London, London, UK.
Jennifer K QuintNational Heart and Lung Institute, Imperial College London, London, UK j.quint@imperial.ac.uk.ORCID http://orcid.org/0000-0003-0149-4869
Imperial College London · GBLung Institute · USRoyal Brompton Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleHeart failure (HF) management in chronic obstructive pulmonary disease (COPD) is often delayed or suboptimal.

objectivesTo examine the effect of HF and HF medication use on moderate-to-severe COPD exacerbations. METHODS AND MEASUREMENTS: Retrospective cohort studies from 2006 to 2016 using nationally representative English primary care electronic healthcare records linked to national hospital and mortality data. Patients with COPD with diagnosed and possible HF were identified. Possible HF was defined as continuous loop diuretic use in the absence of a non-cardiac indication. Incident exposure to HF medications was defined as ≥2 prescriptions within 90 days with no gaps >90 days during ≤6 months of continuous use; prevalent exposure as 6+ months of continuous use. HF medications investigated were angiotensin receptor blockers, ACE inhibitors, beta-blockers, loop diuretics and mineralocorticoid receptor antagonists. Cox regression, stratified by sex and age, further adjusted for patient characteristics, was used to determine the association of HF with exacerbation risk. MAIN

results86 795 patients with COPD were categorised as no evidence of HF (n=60 047), possible HF (n=8476) and newly diagnosed HF (n=2066). Newly diagnosed HF (adjusted HR (aHR): 1.45, 95% CI: 1.30 to 1.62) and possible HF (aHR: 1.65, 95% CI: 1.58 to 1.72) similarly increased exacerbation risk. Incident and prevalent use of all HF medications were associated with increased exacerbation risk. Prevalent use was associated with reduced exacerbation risk compared with incident use.

conclusionsEarlier opportunities to improve the diagnosis and management of HF in the COPD population are missed. Managing HF may reduce exacerbation risk in the long term.

Indexed as

clinical epidemiologyCOPD epidemiologyCOPD exacerbations

Identifiers

PMID33927022
PMCPMC8311079
OpenAlexW3159228093

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.