Outcomes of Percutaneous Coronary Intervention in St Elevation Myocardial Infarction and Chronic Obstructive Pulmonary Disease

Поликутина, О. М.; Слепынина, Ю. С.; Баздырев, Е. Д.; Барбараш, О. Л.

doi:10.15829/1560-4071-2017-11-31-35

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…В последнее десятилетие появляется все больше научных работ, связанных с изучением взаимосвязи ХОБЛ и степени атеросклеротического поражения различных сосудистых бассейнов ввиду общих звеньев патогенеза. По данным некоторых исследователей, к особенностям поражения коронарного русла у больных ИБС с сопутствующей ХОБЛ относятся многососудистое поражение венечных артерий, увеличение общего количества стенозов, тенденция к преобладанию дистальных стенозов в сравнении с таковыми у больных без наличия ХОБЛ в анамнезе [2,3,6,7,9].…”

Section: Amur State Medical Academy 95 Gor'kogo Str Blagoveshchensunclassified

Coronary Circulation Changes in Patients With Chronic Obstructive Pulmonary Disease and St-Segment Elevation Myocardial Infarction: Angiography Data

Dimova¹,

Dimova

2018

Bulletin Physiology and Pathology of Respiration

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The aim of the study was to investigate coronary arteries damage during ST-elevation myocardial infarction (STEMI) manifestation in patients with chronic obstructive pulmonary disease (COPD). The protocols of coronary angiography of 90 patients who suffered STEMI were analyzed. The patients were divided into two groups depending on the presence of COPD. The first group (50 people) was formed from the patients who had ST elevation myocardial infarction (STEMI) and COPD. The second group (40 people) had STEMI and no COPD. It was found that in case of COPD and STEMI comorbidity the number of coronary stenosis is bigger than in case of mono AMI patients. In the group of patients with COPD and STEMI the angiographic picture of atherosclerosis damage of coronary arteries demonstrates the prevalence of medium and distal stenosis of major branches and coronary arteries of the second order unlike the group with isolated STEMI. The number of extended stenosis in the group with the comorbid pathology is also higher. The patients with STEMI have the same number of hemodynamically important stenosis as the other group. The correlation between the change of the vessel channel and smoking anamnesis, the level of the systematic inflammation marker (CRP) and the level of lipids in patients with COPD and STEMI was studied. The severity of coronary atherosclerosis directly correlates with CRP level, smoking anamnesis, level of cholesterol, LDLP. The number of distal stenosis, including those that are hemodynamically important, has reverse correlation with the level of HDLP.

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Section: Amur State Medical Academy 95 Gor'kogo Str Blagoveshchensunclassified

Coronary Circulation Changes in Patients With Chronic Obstructive Pulmonary Disease and St-Segment Elevation Myocardial Infarction: Angiography Data

Dimova¹,

Dimova

2018

Bulletin Physiology and Pathology of Respiration

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Influence of chronic obstructive pulmonary disease on hospital outcomes of percutaneous coronary interventions in patients with acute coronary syndrome

Frolov,

Fedotov,

Frolov

et al. 2024

Terapevticheskii arkhiv

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Aim. To evaluate the impact of chronic obstructive pulmonary disease (COPD) on hospital outcomes of percutaneous coronary interventions (PCI) in patients with acute coronary syndrome (ACS). Materials and methods. A cohort prospective study of the COPD effect on mortality and coronary microvascular obstruction (CMVO, no-reflow) development after PCI in ACS was carried out. 626 patients admitted in 2019–2020 were included, 418 (67%) – men, 208 (33%) – women. Median age – 63 [56; 70] years. Myocardial infarction with ST elevation identified in 308 patients (49%), CMVO – in 59 (9%) patients (criteria: blood flow 3 grade according to TIMI flow grade; perfusion 2 points according to Myocardial blush grade; ST segment resolution 70%). 13 (2.1%) patients died. Based on the questionnaire "Chronic Airways Diseases, A Guide for Primary Care Physicians, 2005", 2 groups of patients were identified: 197 (31%) with COPD (≥17 points) and 429 (69%) without COPD (17 points). Groups were compared on unbalanced data (÷2 Pearson, Fisher exact test). The propensity score was calculated, and a two-way logistic regression analysis was performed. The data were balanced by the Kernel “weighting” method, logistic regression analysis was carried out using “weighting” coefficients. Results as odds ratio (OR) and 95% confidence interval. Results. The conducted research allowed us to obtain the following results, depending on the type of analysis: 1) analysis of unbalanced data in patients with COPD: OR death 3.60 (1.16–11.12); p=0.03; OR CMVO 0.65 (0.35–1.22); p=0,18; 2) two-way analysis with propensity score: OR death 3.86 (1.09–13.74); p=0.04; OR CMVO 0.61 (0.31–1.19); p=0.15; 3) regression analysis with "weight" coefficients: OR death 12.49 (2.27–68.84); p=0.004; OR CMVO 0.63 (0.30–1.33); p=0.22. Conclusion. The presence of COPD in patients with ACS undergoing PCI increases mortality and does not affect the incidence of CMVO.

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Characteristics of changes in the coronary arteries in patients with acute coronary syndrome on the background of chronic obstructive pulmonary disease

Меньшикова

Magalyas

Sklyar

2023

Bûlletenʹ fiziologii i patologii dyhaniâ

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Aim. Study of the nature and characteristics of changes in the coronary bed in patients with acute coronary syndrome (ACS) and chronic obstructive pulmonary disease (COPD).Materials and methods. The study included 85 patients with ACS: group 1 included 47 patients with ACS and COPD, group 2 included 38 patients with ACS. All patients underwent a comprehensive clinical, instrumental and laboratory examination.Results. In the majority of patients of group 1 (76.6%), two- and three-vessel lesions of the coronary bed were revealed, and arterial stenoses were multiple, located mainly in the middle and distal parts of the arteries. In (76.3%) patients of the 2nd group, one- and two-vessel lesions of the coronary bed with localization of stenoses mainly in the proximal and middle segment of the coronary arteries (CA) were revealed. The total number of stenosis and hemodynamically significant stenosis was higher in group 1 compared to group 2 (p=0.01). Extended stenoses were more common in group 1 patients (p=0.04). Damage to the CA of the 2nd order was also higher in the 1st group of patients (p=0.01). The 1st group was divided into two subgroups: 1A (26 people) − patients with COPD of moderate severity and 1B (21 people) − patients with severe COPD. In patients of subgroup 1B, a more significant lesion of the coronary bed was noted due to an increase in the total number of stenoses (p=0.02), hemodynamically significant stenoses (p=0.01), localized in the proximal (p=0.04) and distal (p=0.02) segments of the coronary artery, in the branches of the 2nd order (p=0.02), as well as occlusions and critical stenoses of the coronary artery (p=0.02).Conclusion. The severity of COPD in patients with ACS significantly affects the number of hemodynamically significant proximal and distal stenoses, as well as branches of the second order coronary arteries, which reduces the effectiveness of surgical treatment and worsens the prognosis of patients with comorbidities.

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Outcomes of Percutaneous Coronary Intervention in St Elevation Myocardial Infarction and Chronic Obstructive Pulmonary Disease

Cited by 3 publications

References 9 publications

Coronary Circulation Changes in Patients With Chronic Obstructive Pulmonary Disease and St-Segment Elevation Myocardial Infarction: Angiography Data

Coronary Circulation Changes in Patients With Chronic Obstructive Pulmonary Disease and St-Segment Elevation Myocardial Infarction: Angiography Data

Influence of chronic obstructive pulmonary disease on hospital outcomes of percutaneous coronary interventions in patients with acute coronary syndrome

Characteristics of changes in the coronary arteries in patients with acute coronary syndrome on the background of chronic obstructive pulmonary disease

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