PT  - JOURNAL ARTICLE
AU  - Gerard Criner
AU  - Robert Bourge
AU  - Raymond Benza
AU  - Philip Adamson
AU  - William Abraham
AU  - Jay Yadav
AU  - Brad Jeffries
AU  - Pam Cowart
AU  - Jordan Bauman
AU  - Fernando Martinez
TI  - Impact of a wireless implanted pulmonary artery pressure monitoring system in heart failure patients with comorbid chronic obstructive pulmonary disease
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P971
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P971.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P971.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Introduction: Chronic obstructive pulmonary disease (COPD) is a common comorbidity for heart failure (HF) patients. The presence of high pulmonary artery pressures (PAP) are independently associated with COPD and HF exacerbations.Objectives: We performed a retrospective analysis to evaluate if PAP monitoring and therapy reduced HF hospitalizations (HFH) in HF patients with a medical history of COPD and/or receiving COPD therapies.Methods: The CHAMPION trial enrolled 550 patients with NYHA class III HF who were followed for an average of 15 months. In the treatment group, clinicians used PAP data to guide therapy decisions in addition to standard of care versus standard of care alone in the control group.Results: In the entire CHAMPION cohort, treatment had a 37% reduction in HFH rates (0.46 vs. 0.73, HR 0.63, 95% CI 0.52-0.77, p<0.0001, Anderson-Gill). In the subgroup of 187 patients with comorbid COPD, treatment had a 41% reduction in HFH rates (0.55 vs. 0.96, HR 0.59, 95% CI 0.44-0.81, p=0.0009). Reductions in PAP were analyzed using an area under the curve (AUC) methodology. Overall, treatment had an average AUC reduction of 201.5 mmHg days compared to an increase of 106.5 mmHg days in control (p=0.0299, ANCOVA). In the COPD subgroup, treatment had an average reduction of 353.1 mmHg days compared to a reduction of 57.0 mmHg days in control (p=0.3687).Conclusions: HF patients with COPD experience high HFH rates but have pronounced benefit from PAP monitoring. Further investigations that analyze the relationship between PAP, COPD, and HF and its implication towards new treatment strategies are warranted.