Verification of Budesonide/Glycopyrronium/Formoterol (BGF) Triple Therapy in the Department of Cardiology: A Pilot Study

Background Chronic obstructive pulmonary disease (COPD) frequently coexists with heart failure (HF), worsening patient prognosis. While single-inhaler triple therapy (BGF: budesonide/glycopyrronium/formoterol) is effective, the clinical impact of its initiation by cardiologists, who often manage latent COPD in patients with HF, remains underexplored. This study aimed to evaluate the validity and safety of BGF therapy managed by cardiologists compared to respiratory specialists and to identify prognostic factors associated with acute exacerbations. Methods This retrospective pilot study analyzed 22 outpatients who received BGF therapy between April 2024 and March 2025. Outcomes were compared between the Department of Cardiology and the Department of Pulmonary Medicine. Statistical analyses included Kaplan-Meier survival curves and Cox proportional hazards regression. Results No significant differences were found in mortality, hospitalization, or exacerbation rates between departments. The cardiology group had a significantly higher prevalence of HF and more frequent treatment initiation. Multivariate analysis revealed that comorbid HF significantly increased the risk of acute exacerbations (hazard ratio (HR) > 1), while higher body mass index was a protective factor (obesity paradox). Conclusions BGF triple therapy is safe and effective under cardiologist management. Proactive intervention is particularly justified in patients with HF, where the risk of exacerbation remains high regardless of the severity of the primary respiratory symptom.