Chest
Original ResearchCOPDFeaturedImpact of COPD on Long-term Outcome After ST-Segment Elevation Myocardial Infarction Receiving Primary Percutaneous Coronary Intervention
Section snippets
Study Design
The REAL registry was previously described.8, 9, 10 Briefly, it is a large, prospective, worldwide, web-based registry launched in July 2002 and designed to collect clinical and angiographic data on all consecutive PCIs performed in a 4-million-resident region of Italy. The registry is ongoing. Thirteen public and private centers of interventional cardiology participate in the data collection. Procedural data are retrieved directly and continuously from the resident databases of each
Results
As shown in Table 1, the study population of the present analysis was of 11,118 patients. According to our criteria, 2,032 patients (18.2%) had a diagnosis of COPD before hospital admission for STEMI. Overall, the average age was 66 years, and 72% were men. Compared with patients without COPD, patients with COPD were 5 years older and more likely to have had hypertension, renal disease, coronary artery disease, and bleeding event previously diagnosed (Table 1). As expected, smoking habits
Discussion
The results of this large observational multicenter study among residents of Emilia-Romagna, an Italian region, hospitalized with STEMI and treated with primary PCI demonstrated significant differences among patients with and without concomitant COPD with regard to clinical presentation, treatments received, and long-term outcomes. Patients with COPD were more likely to have pulmonary edema at entry; were less likely to receive glycoprotein IIb/IIIa inhibitors, drug-eluting stents, and
Conclusions
COPD is a frequent comorbidity in patients admitted to the hospital for STEMI. Our analysis showed that, in spite of recent progress in the treatment of cardiac and pulmonary diseases, STEMI patients with concomitant COPD are at increased risk for death and hospital readmissions as compared with those without COPD as comorbidity.
Acknowledgments
Author contributions: Drs Campo and Saia and Mr Guastaroba are the guarantors of the paper, taking responsibility for the integrity of the work as a whole, from inception to published article.
Dr Campo: contributed to conception and design, acquisition of data, analysis and interpretation of data, drafting the submitted article, and revising it critically for important intellectual content.
Mr Guastaroba: contributed to conception and design, acquisition of data, and analysis and interpretation
References (13)
- et al.
COPD: focus on prevention: recommendations of the National Lung Health Education Program. Chronic obstructive pulmonary disease
Heart Lung
(2000) - et al.
Impact of chronic obstructive pulmonary disease on post-myocardial infarction outcomes
Am J Cardiol
(2007) - et al.
Impact of chronic obstructive pulmonary disease on long-term outcome of patients hospitalized for heart failure
Am J Cardiol
(2008) - et al.
Coronary artery bypass grafting in patients with COPD
Chest
(1998) - et al.
Prevalence and prognosis of chronic obstructive pulmonary disease among 5,839 consecutive patients with acute myocardial infarction
Am J Med
(1992) - et al.
Impact of chronic obstructive pulmonary disease on acute-phase outcome of myocardial infarction
Am J Cardiol
(2010)
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Funding/Support: The authors have reported to CHEST that no funding was received for this study.
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