Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions
- PMID: 29112944
- DOI: 10.20452/pamw.4145
Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions
Abstract
INTRODUCTION The incidence of chronic obstructive pulmonary disease (COPD) in patients treated with percutaneous coronary intervention (PCI) is underestimated, and the effect of COPD on atherosclerosis and the outcomes of PCI is not fully understood. OBJECTIVES The aim of this study was to assess the impact of COPD on periprocedural outcomes of PCI, as well as its relationship with clinical presentation and the type of coronary artery lesions. PATIENTS AND METHODS Data were prospectively collected using a national electronic registry of PCI procedures performed in Poland between January 2015 and December 2016. Out of the 221 187 PCIs, 5594 patients had been diagnosed with COPD before the intervention. RESULTS Patients with COPD were older than those without COPD (mean [SD] age, 70.3 [9.9] years vs 67 [10.8] years; P <0.001) and more often were males (72.3% vs 67.8%; P <0.001). Non-ST‑segment elevation myocardial infarction (NSTEMI) was a more common clinical presentation of coronary artery disease (CAD) in the COPD group, while ST‑segment elevation myocardial infarction (STEMI) occurred more frequently in the non‑COPD group. Multivessel disease (MVD) with or without left main coronary artery (LMCA) involvement and separate LMCA was diagnosed more often in the COPD group. At baseline, the culprit lesion was more often restenosis and in‑stent thrombosis in the COPD group, whereas de‑novo lesion-in the non‑COPD group. The rates of periprocedural mortality and myocardial infarction did not differ between the groups with and without COPD (0.13% vs 0.12%, P = 0.88 and 0.53% vs 0.45%, P = 0.39, respectively). COPD was found to be an independent predictor of restenosis assessed before PCI in patients with a history of PCI (P = 0.006). CONCLUSIONS Patients with COPD diagnosed before PCI are at an increased risk of MVD with or without LMCA involvement and NSTEMI. Restenosis and in‑stent thrombosis occur more often in patients with COPD before PCI.
Comment in
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Long‑term management of patients with chronic obstructive pulmonary disease who undergo percutaneous coronary intervention still needs to be dramatically improved.Pol Arch Intern Med. 2018 Jan 31;128(1):4-6. doi: 10.20452/pamw.4197. Epub 2018 Jan 31. Pol Arch Intern Med. 2018. PMID: 29385114 No abstract available.
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Chronic obstructive pulmonary disease affects angiographic presentation and outcomes. Authors' reply.Pol Arch Intern Med. 2018 Mar 29;128(3):195-196. doi: 10.20452/pamw.4237. Epub 2018 Mar 29. Pol Arch Intern Med. 2018. PMID: 29600970 No abstract available.
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Chronic obstructive pulmonary disease affects angiographic presentation and outcomes.Pol Arch Intern Med. 2018 Mar 29;128(3):195. doi: 10.20452/pamw.4236. Epub 2018 Mar 29. Pol Arch Intern Med. 2018. PMID: 29600971 No abstract available.
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