Interplay between acute heart failure and COPD in patients hospitalized for dysponea: prognostic insights from the PARADISE cohort

doi:10.1093/eschf/xvag136

Heart failure & cardiomyopathiesCohort study

Interplay between acute heart failure and chronic obstructive pulmonary disease (COPD) in patients hospitalized for dysponea: prognostic insights from the PARADISE cohort

ESC Heart FailPublished 23 May 2026

monocentric observational study

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Authors' conclusion

HF and COPD frequently coexist and are both associated with an increased long-term mortality risk, with a greater prognostic impact of HF in patients with COPD. These findings highlight the importance of systematic identification and optimized management of both conditions in this high-risk population.

Study context

Population: Patients admitted to the emergency department (ED) for acute dyspnoea between 2010 and 2019 with a primary diagnosis of heart failure (HF) or COPD, stratified according to the presence of the alternate conditionprimary diagnosis of HF 3,543 · primary diagnosis of COPD 1,588
Participants: 5,131 patients

Exposure: Patients with a primary diagnosis of HF or COPD stratified according to the presence of the alternate condition
Outcome: In-hospital and post-discharge all-cause mortality

Main finding

As reported in the abstract

Primary HF with COPD

8.5%

In-hospital mortality · Overall mortality 69.3%

Primary HF without COPD

11.7%

In-hospital mortality · Overall mortality 68.9%

Primary COPD with HF

7.4%

In-hospital mortality · Long-term mortality 68.7%

Primary COPD without HF

3.4%

In-hospital mortality · Long-term mortality 48.7%

Estimate (95% CI)P value

Primary HF with COPD vs Primary HF without COPDadjusted; in-hospital mortality

OR 0.74(0.55–0.99)

P = 0.050

Primary HF with COPD vs Primary HF without COPDadjusted; long-term mortality

HR 1.22(1.09–1.36)

P < 0.001

Primary COPD with HF vs Primary COPD without HFadjusted; in-hospital mortality

OR 1.54(0.87–2.65)

P = 0.13

Primary COPD with HF vs Primary COPD without HFadjusted; long-term mortality

HR 1.48(1.25–1.76)

P < 0.001

Observational data: associations, not effects.

Further findings

Concomitant disease

Concomitant disease present in both groups: approximately 20%

Original publication

Interplay between acute heart failure and COPD in patients hospitalized for dysponea: prognostic insights from the PARADISE cohort. ESC Heart Fail. Published 23 May 2026. doi:10.1093/eschf/xvag136

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Summarised from the published abstract; every number is checked against it