Mooney L, Hawkins NM, Jhund PS, et al. - In this study population, the presence of concomitant chronic obstructive pulmonary disease (COPD) was found in approximately 1 in 7 patients with heart failure with preserved ejection fraction (HFpEF). Greater functional limitation as well as a higher risk of heart failure hospitalization and death was observed in relation to the presence of concomitant COPD in these patients.

• In the PARAGON‐HF trial, outcomes were examined in 4791 patients with HFpEF, by COPD status; COPD was present in 670 (14%).

• Presence of echocardiographic right ventricular enlargement, higher serum creatinine (100 μmol/L vs 96 μmol/L) and neutrophil‐to‐lymphocyte ratio (2.7 vs 2.5) was detected in patients with COPD vs those without COPD.

• Worse results were reported in relation to COPD post-multivariable adjustment: adjusted rate ratio for the primary outcome (defined as a composite of first and recurrent hospitalizations for heart failure and cardiovascular death) 1.51, total heart failure hospitalization 1.54, cardiovascular death (adjusted hazard ratio [HR], 1.42), and all‐cause death (adjusted HR, 1.52).

• Relative to other comorbidities, COPD was linked with worse outcomes.

• In those with COPD, greater decline of Kansas City Cardiomyopathy Questionnaire Clinical Summary Scores was evident vs those without.