Impact of chronic obstructive pulmonary disease on in-hospital morbidity and mortality in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention

Șerban, Răzvan Constantin; Hadadi, László; Șuș, Ioana; Lakatos, Eva Katalin; Demjen, Zoltan; Scridon, Alina

doi:10.1016/j.ijcard.2017.05.044

Cited by 13 publications

(11 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some studies have been performed to explore the impact of COPD on the outcomes of PCI in depth using hospital or registry databases, yet the early outcome regarding COPD patients vs those without COPD remained inconsistent 12–20. As found in our study, COPD patients were commonly older and had multiple comorbidities, which may increase the risk of hospital mortality.…”

Section: Discussionmentioning

confidence: 62%

“…Notably, even after controlling for potential confounding factors, COPD increased a modest but significant risk of hospital mortality following PCI. Such a modest increase in the risk of hospital mortality may explain the inconsistent results reported in the literature 12–20…”

Section: Discussionmentioning

confidence: 99%

“…However, outcomes of patients experiencing recent hospitalized exacerbations before PCI have not been elucidated. Also, some studies demonstrated that COPD patients were at increased risk for hospital mortality,13,18,20 while others did not find an adverse effect of COPD 12,14–17,19. In the era of widespread use of PCI, the prognostic significance of COPD and recent hospitalized exacerbations need further clarification.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The association between recent hospitalized COPD exacerbations and adverse outcomes after percutaneous coronary intervention: a nationwide cohort study

Lin¹,

Chen²,

Lu³

et al. 2019

COPD

View full text Add to dashboard Cite

PurposeCOPD is associated with coronary artery disease, and exacerbations are major events in COPD. However, the impact of recent hospitalized exacerbations on outcomes of percutaneous coronary intervention (PCI) remains underdetermined.Patients and methodsUsing the National Health Insurance Research Database of Taiwan, we identified 215,275 adult patients who underwent first-time PCI between 2000 and 2012. Among these patients, 15,485 patients had COPD. The risks of hospital mortality, overall mortality, and adverse cardiovascular outcomes after PCI (ie, ischemic events, repeat revascularization, cerebrovascular events, and major adverse cardiac and cerebrovascular events [MACCEs]) in relation to COPD, and the frequency and timing of recent hospitalized exacerbations within 1 year before PCI were estimated.ResultsCOPD was independently associated with increased risks of hospital mortality, overall mortality, ischemic events, cerebrovascular events, and MACCE during follow-up after PCI. Among cerebrovascular events, ischemic rather than hemorrhagic stroke was more likely to occur. In COPD patients, recent hospitalized exacerbations further increased the risks of overall mortality, ischemic events, and MACCE following PCI. Notably, patients with more frequent or more recent hospitalized exacerbations had a trend toward higher risks of these adverse events (all P-values for trend <0.0001), especially those with ≥2 exacerbations within 1 year or any exacerbation within 1 month before PCI.ConclusionIntegrated care is urgently needed to alleviate COPD-related morbidity and mortality after PCI, especially for patients with a recent hospitalized exacerbation.

show abstract

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The association between recent hospitalized COPD exacerbations and adverse outcomes after percutaneous coronary intervention: a nationwide cohort study

Lin¹,

Chen²,

Lu³

et al. 2019

COPD

View full text Add to dashboard Cite

show abstract

“…The short-term clinical evolution of patients treated by PCI in Romania is well documented, most of the studies reporting in-hospital-or 30-day mortality as a clinical outcome [3][4][5][6][7][8][9][10][11] . However, contemporary data regarding long term mortality of CAD treated by PCI is mainly lacking in Romania: a few studies evaluated this subject, and only for special PCI indications, such as acute ST-elevation myocardial infarction (STEMI; 1-year follow-up) 12,13 or STEMI complicating left main CAD (1-and 3-year follow-up) 14,15 .…”

Section: Assessed Demographic Clinical and Procedural Variablesmentioning

confidence: 99%

Mortality predictors after percutaneous coronary intervention – a prospective single-center registry study

Hadadi¹,

Calburean²,

Grebenişan³

et al. 2020

Rom. J Cardio

View full text Add to dashboard Cite

Objectives – To evaluate the predictors of three-year cardiovascular mortality after percutaneous coronary intervention (PCI) in a Romanian tertiary cardiovascular center. Methods – Consecutive patients treated by PCI in the Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures were included prospectively in a local PCI Registry. Demographic, clinical, and procedural parameters of the patients enrolled in the year 2016 were statistically analyzed as possible predictors of three-year cardiovascular mortality post-PCI. Results – 1079 patients were included: 254 (23.5%) with ST-segment elevation acute myocardial infarction (STEMI), 278 (25.8%) with non-ST segment elevation acute coronary syndrome (NSTEACS) and 547 (50.7%) with chronic coronary syndrome (CCS). Three-year cardiovascular mortality was 20.1%, 10.8% and 5.7% after PCI for STEMI, NSTEACS and CCS, respectively. Cox proportional hazards regression evidenced as independent predictors of long-term mortality after PCI: low left ventricular ejection fraction (LVEF), renal dysfunction, presentation with cardiogenic shock or with cardiac arrest in the case of acute coronary syndromes, and the history of signifi cant valvular heart disease and low LVEF in the case of CCS (all p ≤0.01). Conclusions – Simple clinical variables but no procedural factors were the main predictors of 3-year cardiovascular mortality after PCI in this all-comers population.

show abstract

“…Chronic obstructive pulmonary disease is a predictor of worse in-hospital survival in those presenting with ACS. 5 –8 The COPD cohorts were found to have more severe coronary artery disease on coronary angiography 9 –11 and lower utilization of β-blockers, statins, and coronary interventions. 6 –8 The guidelines for NSTE-ACS recommend early invasive strategy (EIS), invasive strategy, or ischemia-guided strategy (IGS) based on clinical presentation and high-risk comorbidities (ie, prior coronary artery bypass).…”

Section: Introductionmentioning

confidence: 99%

Early Invasive Versus Ischemia-Guided Strategy in Non-ST-Segment Elevation Acute Coronary Syndrome With Chronic Obstructive Pulmonary Disease: A National Inpatient Sample Analysis

et al. 2019

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) is a risk factor for non-ST-segment elevation–acute coronary syndromes (NSTE-ACS). Whether early invasive strategy (EIS) or ischemia-guided strategy (IGS) confers better outcomes in NSTE-ACS with COPD is largely unknown. Nationwide Inpatient Sample database of the United States was queried from 2010 to 2015 to identify NSTE-ACS with and without COPD. Early invasive strategy was defined as coronary angiogram with or without revascularization on admission day 0 or 1, whereas IGS included patients who did not receive EIS. Standardized morbidity ratio weight was used to calculate the adjusted odds ratio. A total of 228 175 NSTE-ACS admissions with COPD were identified of which 34.0% received EIS. In-hospital mortality was lower with EIS in patients with COPD (3.1% vs 5.5%, adjusted odds ratio 0.57, 95% confidence interval 0.50-0.63) compared to IGS, but the magnitude of mortality reduction observed in EIS in patients with COPD was less compared to non-COPD patients ( P interaction = .02). Length of stay was shorter (4.2 vs 4.7 days, P < .0001) but the cost was higher (US$23 804 vs US$18 533, P < .0001) in EIS in COPD. Early invasive strategy resulted in lower in-hospital mortality and marginally shorter length of stay but higher hospitalization cost in NSTE-ACS with COPD.

show abstract

Impact of chronic obstructive pulmonary disease on in-hospital morbidity and mortality in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention

Cited by 13 publications

References 26 publications

The association between recent hospitalized COPD exacerbations and adverse outcomes after percutaneous coronary intervention: a nationwide cohort study

The association between recent hospitalized COPD exacerbations and adverse outcomes after percutaneous coronary intervention: a nationwide cohort study

Mortality predictors after percutaneous coronary intervention – a prospective single-center registry study

Early Invasive Versus Ischemia-Guided Strategy in Non-ST-Segment Elevation Acute Coronary Syndrome With Chronic Obstructive Pulmonary Disease: A National Inpatient Sample Analysis

Contact Info

Product

Resources

About