Key result
Asthma/COPD plus psychosocial distress in NYHA II HF linked to ~10-fold higher 12-month hospitalization or death.
Why the study?
Data on the combination of heart failure, asthma or COPD, and psychosocial distress differentiated by asthma/COPD and heart failure type or severity were scarce.
Does psychosocial distress worsen the 12-month prognosis of hospitalization or death in heart failure patients with comorbid asthma or COPD across different NYHA classes?
Cohort (n=3,117)
Yes
Does psychosocial distress worsen the 12-month prognosis of hospitalization or death in heart failure patients with comorbid asthma or COPD across different NYHA classes?
Effect estimate: HR 10.06 (95% CI 1.118-90.498)
p-value: p=0.039
The combination of psychosocial distress and asthma/COPD in heart failure patients significantly worsens 12-month prognosis, particularly in those with NYHA class II symptoms.
May warrant PSD screening/support in NYHA II HF with asthma/COPD; leaves open benefit of targeted interventions pending validation.
Background Investigations on the combination of the comorbidities heart failure (HF), asthma/chronic obstructive pulmonary disease (COPD), and psychosocial distress (PSD) differentiated by asthma/COPD and HF type or severity are scarce. Aim To investigate the impact of PSD on prognosis in HF patients with comorbid asthma/COPD depending on the HF severity. Design & setting A secondary analysis of the prospective observational cohort RECODE-HF study. Method Kaplan-Meier curves (log-rank tests) illustrate the time to the composite endpoint (12-month hospitalization or death) in the asthma/COPD-PSD subgroups within each NYHA functional class. Prognostic analyses include multivariable Cox proportional hazards regression ( n =2499) including potential confounding conditions. Results In total, 780 endpoints occurred (649 hospitalizations;131 deaths). Kaplan-Meier analysis revealed a significant reduction in estimated mean time to composite endpoint: -31 days (hazard ratio, HR 1.901;CI95% 1.325-2.674) in asthma/COPD/PSD+NYHA II; -47 days (HR 1.981;CI95% 1.364-2.879) and -40 days (HR 1.867;CI95% 1.361-2.561) in asthma/COPD/PSD+and no-asthma-or-COPD/PSD+in NYHA III; -93 days in no-asthma-or-COPD/PSD+NYHA IV (HR 2.457;CI95% 1.015-5.945) (reference no-asthma-or-COPD/PSD-; NYHA I). Cox regression showed a significant global three-way interaction regarding hospitalization or death between NYHA class, asthma/COPD, PSD ( P =0.037), and a 10.06-fold hazard (CI95% 1.118-90.498) regarding the NYHA class II subgroup*asthma/COPD*PSD ( P =0.039). Conclusion Comorbidity of HF, asthma/COPD and PSD showed an impact on prognosis by the NYHA functional class. Future research needs to investigate the special needs of patients with PSD and asthma/COPD with focus on those in NYHA class II. PSD screening seems relevant to identify patients with especially poor prognosis.
No takes yet. Share an insight, caveat, or question.
Boczor et al. (2026) conducted a cohort in Heart failure with comorbid asthma/COPD and psychosocial distress (n=3,117). Comorbid asthma/COPD and psychosocial distress (PSD) vs. No asthma/COPD and no PSD was evaluated on Composite of 12-month hospitalization or death (HR 10.06, 95% CI 1.118-90.498, p=0.039). In heart failure patients in NYHA class II, the combination of comorbid asthma or COPD and psychosocial distress was associated with a 10.06-fold higher hazard of 12-month hospitalization or death.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: