Long-term Beneficial Effect of Coronary Artery Bypass Grafting in Patients With COPD

Medalion, Benjamin; Katz, Michael G.; Cohen, Andrew I.; Hauptman, Eli; Sasson, Lior; Schachner, Arie

doi:10.1378/chest.125.1.56

Cited by 46 publications

(30 citation statements)

References 16 publications

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“…This is in agreement with Medalion and coworkers who found COPD as a risk factor for decreased survival after CABG [8]. But this group also found out that Chronic renal insufficiency with a serum creatinine O1.5 mg/dl and serum creatinine O 2 mg/dl has been shown to decrease long-term survival after CABG [6,9].…”

Section: Discussionsupporting

confidence: 90%

The influence of ascending aortic atherosclerosis on the long-term survival after CABG

Schachner

Zimmer

Nagele

et al. 2005

European Journal of Cardio-Thoracic Surgery

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Section: Discussionsupporting

confidence: 90%

The influence of ascending aortic atherosclerosis on the long-term survival after CABG

Schachner

Zimmer

Nagele

et al. 2005

European Journal of Cardio-Thoracic Surgery

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“…However, it is well described that patients with COPD who undergo CABG are at higher risk of both in-hospital complications, including death, atrial fi brillation, and pneumonia, and poor long-term outcomes, including higher mortality. [4][5][6] Thus, further evaluation of this referral pattern is warranted to determine the best clinical outcomes in this high-risk patient population. Patients with COPD were more likely to experience major entry site complications than patients without COPD.…”

Section: Use Of Medications At Dischargementioning

confidence: 99%

Increased Adverse Events After Percutaneous Coronary Intervention in Patients With COPD

Enriquez

Parikh

Selzer

et al. 2011

Chest

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COPDOriginal Research tion (PCI) for revascularization. Although patients with COPD currently make up almost 10% of patients undergoing PCI, 7 limited data reveal an increased risk of mortality. [7][8] Potential factors associated with this A mong the 10 most common causes of death in the United States, COPD is the only one that is increasing in frequency. 1 Independent of smoking status, patients with COPD are at increased risk for cardiovascular disease. 2 Additionally, the presence of coronary artery disease in these patients is associated with increased mortality and decreased quality of life. 3 Management of coronary artery disease in patients with chronic COPD can present therapeutic challenges. Given that COPD is associated with higher risk for adverse events after coronary artery bypass graft surgery (CABG), 4-6 patients with COPD may be preferentially referred for percutaneous coronary intervenBackground: Previous studies have demonstrated that patients with COPD are at higher risk for death after percutaneous coronary intervention (PCI), but other clinical outcomes and possible associations with adverse events have not been described. Methods: Using waves 1 through 5 (1999-2006) of the National Heart, Lung, and Blood Institute Dynamic Registry, patients with COPD (n 5 860) and without COPD (n 5 10,048) were compared. Baseline demographics, angiographic characteristics, and in-hospital and 1-year adverse events were compared. Results: Patients with COPD were older (mean age 66.8 vs 63.2 years, P , .001), more likely to be women, and more likely to have a history of diabetes, prior myocardial infarction, peripheral arterial disease, renal disease, and smoking. Patients with COPD also had a lower mean ejection fraction (49.1% vs 53.0%, P , .001) and a greater mean number of signifi cant lesions (3.2 vs 3.0, P 5 .006). Rates of in-hospital death (2.2% vs 1.1%, P 5 .003) and major entry site complications (6.6% vs 4.2%, P , .001) were higher in pulmonary patients. At discharge, pulmonary patients were signifi cantly less likely to be prescribed aspirin (92.4% vs 95.3%, P , .001), b -blockers (55.7% vs 76.2%, P , .001), and statins (60.0% vs 66.8%, P , .001). After adjustment, patients with COPD had signifi cantly increased risk of death (hazard ratio [HR] 5 1.30, 95% CI 5 1.01-1.67) and repeat revascularization (HR 5 1.22, 95% CI 5 1.02-1.46) at 1 year, compared with patients without COPD. Conclusions: COPD is associated with higher mortality rates and repeat revascularization within 1 year after PCI. These higher rates of adverse outcomes may be associated with lower rates of guidelinerecommended class 1 medications prescribed at discharge. CHEST 2011; 140(3):604-610Abbreviations: CABG 5 coronary artery bypass graft surgery; CHF 5 congestive heart failure; HR 5 hazard ratio; MACE 5 major adverse cardiac event; MI 5 myocardial infarction; NHLBI 5 National Heart, Lung, and Blood Institute; PCI 5 percutaneous coronary intervention

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“…In patients undergoing CABG, the effect of COPD becomes a substantial problem due to the additional influence of CPB and sternotomy [4]. COPD has been defined as the most important preoperative risk factor for morbidity and mortality in patients on whom coronary artery surgery is performed [5,6]. Unwanted events of the respiratory system, such as respiratory failure and pneumonia, can cause postoperative complication in COPD patients on whom CABG is performed [7].…”

Section: Discussionmentioning

confidence: 99%

Arterial Blood Gas Analysis in Chronic Obstructive Pulmonary Disease Patients Undergoing Coronary Artery Bypass Surgery

İlhan¹,

Günay

Özkan

et al. 2016

Turk Toraks Dergisi

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OBJECTIVES:We aimed to investigate the impact of arterial blood gas (ABG) on morbidity and mortality in chronic obstructive pulmonary disease (COPD) patients undergoing CABG surgery. MATERIAL AND METHODS:The records for 75 COPD patients who underwent elective CABG surgery our institution clinic between November 2008 to 2011 and had a forced expiratory volume in 1 second (FEV 1 ) /forced vital capacity (FVC) ≤ 70% value in the pulmonary function tests (PFT) performed prior to the surgery were evaluated retrospectively. COPD patients were divided into two groups; Group 1; FEV 1 ≥ 60% and Group 2; FEV 1 ≤ 59%. Groups were compared for mortality and adverse events after identification of other preoperative and postoperative factors that could affect mortality and adverse events. An ABG was obtained immediately before and 3 to 6 hours after surgery to study the predictive value of ABG in seperate COPD groups. RESULTS:There were no significant differences in patients with high partial pressure carbondioxide (PaCO 2 ) preoperative values compared to patients with normal values. Also there were no significant differences in patients with lower partial pressure of oxygen (PaO 2 ) preoperative values compared to patients with normal values in terms of mortality. Postoperative myocardial infarction (MI) was significantly higher in patients with low PaO 2 values (p< 0.05). CONCLUSION:In conclusion, in our study, there could not be found a relation between the degree of preoperative obstruction and mortality for COPD patients who underwent CABG surgery. ABG was not found useful for predicting mortality in COPD patients undergoing CABG surgery, but could be useful to predict postoperative MI in patients with COPD.

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Long-term Beneficial Effect of Coronary Artery Bypass Grafting in Patients With COPD

Cited by 46 publications

References 16 publications

The influence of ascending aortic atherosclerosis on the long-term survival after CABG

The influence of ascending aortic atherosclerosis on the long-term survival after CABG

Increased Adverse Events After Percutaneous Coronary Intervention in Patients With COPD

Arterial Blood Gas Analysis in Chronic Obstructive Pulmonary Disease Patients Undergoing Coronary Artery Bypass Surgery

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