# PARADISE-cohort: hartfalen en COPD samen verhogen de langetermijnmortaliteit, met name HF

*geplaatst 2026-06-05 · Hartfalen · ESC heart failure · doi 10.1093/eschf/xvag136 · https://hartvaat.nl/2026/05/23/paradise-cohort-hartfalen-en-copd-samen-verhogen-de-langetermijnmortaliteit-met-/*

Monocentrische observationele studie (PARADISE-cohort) bij 5.131 patiënten die tussen 2010 en 2019 op de spoedeisende hulp werden opgenomen met acute dyspneu. 3.543 hadden een primaire diagnose hartfalen, 1.588 COPD; in beide groepen had circa 20% het andere ziektebeeld ook. Bij primair HF was concomitante COPD verrassend geassocieerd met lagere ziekenhuissterfte (8,5% vs 11,7%; aOR 0,74), maar wel met iets hogere langetermijnsterfte (aHR 1,22). Bij primair COPD verhoogde concomitant HF de ziekenhuissterfte (7,4% vs 3,4%) niet meer significant na correctie, maar verdrievoudigde wel de langetermijnsterfte (68,7% vs 48,7%; aHR 1,48). Systematische identificatie en optimale behandeling van beide aandoeningen op de SEH zijn cruciaal voor deze hoogrisicogroep.

## English: 

Monocentric observational study (PARADISE cohort) of 5,131 patients admitted to the emergency department for acute dyspnea between 2010 and 2019. 3,543 had a primary diagnosis of heart failure, 1,588 of COPD; in both groups ~20% had the other condition. Among primary HF patients, concomitant COPD was paradoxically associated with lower in-hospital mortality (8.5% vs 11.7%; aOR 0.74) but modestly higher long-term mortality (aHR 1.22). Among primary COPD patients, concomitant HF was not significantly associated with in-hospital mortality after adjustment but markedly increased long-term mortality (68.7% vs 48.7%; aHR 1.48). Systematic identification and optimised management of both conditions in the ED are crucial for this high-risk population.

## Abstract (original, from the publication)

BACKGROUND: Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are leading causes of acute dyspnea in the emergency department (ED) and frequently coexist. However, their combined impact on short- and long-term outcomes in the acute setting remains insufficiently characterized. METHODS: We conducted a monocentric observational study based on the PARADISE cohort, including patients admitted to the ED for acute dyspnea between 2010 and 2019. Patients with a primary diagnosis of HF or COPD were included and stratified according to the presence of the alternate condition. The primary outcomes were in-hospital and post-discharge all-cause mortality, assessed using multivariable regression models. RESULTS: Among 5,131 patients, 3,543 had a primary diagnosis of HF and 1,588 of COPD. Concomitant disease was present in approximately 20% of patients in both groups.In the primary HF cohort, patients with COPD had lower in-hospital mortality compared with those without COPD (8.5% vs. 11.7%, p = 0.014), but similar overall mortality (69.3% vs. 68.9%). After adjustment, COPD remained associated with lower in-hospital mortality (OR 0.74; 95% CI 0.55-0.99; p = 0.050) and with a modest increase in long-term mortality (HR 1.22; 95% CI 1.09-1.36; p < 0.001).In the primary COPD cohort, patients with HF had higher in-hospital mortality (7.4% vs. 3.4%, p = 0.001) and markedly higher long-term mortality (68.7% vs. 48.7%, p < 0.001). After adjustment, HF was not significantly associated with in-hospital mortality (OR 1.54; 95% CI 0.87-2.65; p = 0.13), but remained strongly associated with increased long-term mortality (HR 1.48; 95% CI 1.25-1.76; p < 0.001). CONCLUSIONS: 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.

Auteurs: Guillaume Baudry, Lucie Ferreira, Luca Monzo, Claire Lacomblez, Emmanuel Bresso, Kevin Duarte, Charlène Duchanois, Déborah Jaeger, Tahar Chouihed, Nicolas Girerd

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Bron: ESC heart failure, https://doi.org/10.1093/eschf/xvag136. Bijgewerkt 2026-07-03T13:31:54Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.