Introduction Cardiac Infarction Injury Score (CIIS) and right heart dysfunction (P pulmonale) may aid as ECG prognostic tools to identify COPD patients benefiting from triple therapy.

Aim Assess association of CIIS and P pulmonale with adverse outcomes and treatment response.

Methods IMPACT post hoc analysis assessed risk of death, hospitalization, CVAESI, or exacerbation by CIIS (CIIS?20 vs <20) and P pulmonale (yes vs no), and by treatment (FF/UMEC/VI vs FF/VI and UMEC/VI), using t-test, Fisher?s exact test, Cox proportional hazards models or generalized linear modeling as appropriate.

Results Patients with CIIS?20 had significantly greater risk of worse clinical outcomes vs CIIS<20 (Figure 1). Patients with P pulmonale had similar results, except for CVAESI. In those with CIIS?20 FF/UMEC/VI was associated with lower risk of CVAESI vs UMEC/VI; in those with P pulmonale FF/UMEC/VI was associated with lower risk of hospitalization or death vs FF/VI and UMEC/VI (Figure 2).

Conclusion COPD patients with CIIS?20 or P pulmonale have increased risk of adverse outcomes and may benefit most from triple therapy.

Funding GSK: 116855/NCT02164513