Chronic obstructive pulmonary disease in patients with coronary heart disease worsens long-term prognosis after percutaneous coronary interventions

Abstract

Aim To evaluate the incidence rate of major adverse cardiovascular events (MACVE) in the long-term following percutaneous coronary interventions (PCCI) in patients with acute and chronic ischemic heart disease (IHD) and the contribution of concurrent chronic obstructive pulmonary disease (COPD) to the long-term prediction.Material and methods This prospective cohort study included 254 patients with IHD and concurrent COPD and 392 patients with IHD without COPD. PCCI was performed in all patients: for acute coronary syndrome in 295 patients and for chronic IHD in 351 patients. The follow-up period lasted for up to 36 months. The outcome was a composite endpoint, MACVE, that included cardiovascular death, myocardial infarction, stroke, repeated unscheduled myocardial revascularization (MR), and the time to the event.Results The age-standardized incidence of MACVE in patients with IHD and COPD was 31.5 vs. 23.2 % in patients with IHD without concurrent COPD (p=0.025), primarily due to an increased frequency of repeated unscheduled MR (20.5 vs. 14.0 %, p=0.041), which was associated with earlier occurrence of adverse events (p<0.001). Repeated unscheduled MR was more frequently performed in patients with moderate COPD; the frequency of MR decreased with increasing severity of COPD, whereas the total incidence of cardiovascular death, myocardial infarction, and stroke was the highest in patients with severe and very severe COPD.Conclusion The presence of concurrent COPD increases the relative risk of MACVE 1.36 times (95 % confidence interval: 1.05–1.75) and facilitates their earlier development. Repeated unscheduled MR makes the major contribution to the increase in the total risk (relative risk, 1.46; 95 % confidence interval: 1.03–2.06). The increase in severity of COPD is associated with the increase in total frequency of MACVE (p=0.005).

Recent Advances of Using Exosomes as Diagnostic Markers and Targeting Carriers for Cardiovascular Disease

“…32 One of the most severe types of coronary heart disease is acute coronary syndrome (ACS), which is secondary to the rupture or erosion of coronary atherosclerotic plaques. 33 If ACS is diagnosed and treated early, mortality can be greatly reduced, with reduced complications and improved outcomes. 34 Exosomes are used as diagnostic markers in coronary heart disease, such as atherosclerosis, ACS, and myocardial infarction (MI) (Table 1), and miRNAs, circRNAs, proteins, and metabolites are involved.…”

“…Coronary heart disease is the most common and severe CVD . One of the most severe types of coronary heart disease is acute coronary syndrome (ACS), which is secondary to the rupture or erosion of coronary atherosclerotic plaques . If ACS is diagnosed and treated early, mortality can be greatly reduced, with reduced complications and improved outcomes .…”