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Multicenter Study
. 2022 Aug 15;23(1):207.
doi: 10.1186/s12931-022-02128-0.

Impact of chronic obstructive pulmonary disease on short-term outcome in patients with ST-elevation myocardial infarction during COVID-19 pandemic: insights from the international multicenter ISACS-STEMI registry

Giuseppe De Luca  1   2 , Matteo Nardin  3 , Magdy Algowhary  4 , Berat Uguz  5 , Dinaldo C Oliveira  6 , Vladimir Ganyukov  7 , Zan Zimbakov  8 , Miha Cercek  9 , Lisette Okkels Jensen  10 , Poay Huan Loh  11 , Lucian Calmac  12 , Gerard Roura Ferrer  13 , Alexandre Quadros  14 , Marek Milewski  15 , Fortunato Scotto di Uccio  16 , Clemens von Birgelen  17 , Francesco Versaci  18 , Jurrien Ten Berg  19 , Gianni Casella  20 , Aaron Wong Sung Lung  21 , Petr Kala  22 , José Luis Díez Gil  23 , Xavier Carrillo  24 , Maurits Dirksen  25 , Victor M Becerra-Munoz  26 , Michael Kang-Yin Lee  27 , Dafsah Arifa Juzar  28 , Rodrigo de Moura Joaquim  29 , Roberto Paladino  30 , Davor Milicic  31 , Periklis Davlouros  32 , Nikola Bakraceski  33 , Filippo Zilio  34 , Luca Donazzan  35 , Adriaan Kraaijeveld  36 , Gennaro Galasso  37 , Arpad Lux  38 , Lucia Marinucci  39 , Vincenzo Guiducci  40 , Maurizio Menichelli  41 , Alessandra Scoccia  42 , Aylin Hatice Yamac  43 , Kadir Ugur Mert  44 , Xacobe Flores Rios  45 , Tomas Kovarnik  46 , Michal Kidawa  47 , Josè Moreu  48 , Vincent Flavien  49 , Enrico Fabris  50 , Iñigo Lozano Martínez-Luengas  51 , Marco Boccalatte  52 , Francisco Bosa Ojeda  53 , Carlos Arellano-Serrano  54 , Gianluca Caiazzo  55 , Giuseppe Cirrincione  56 , Hsien-Li Kao  57 , Juan Sanchis Forés  58 , Luigi Vignali  59 , Helder Pereira  60 , Stephane Manzo  61 , Santiago Ordoñez  62 , Alev Arat Özkan  63 , Bruno Scheller  64 , Heidi Lehtola  65 , Rui Teles  66 , Christos Mantis  67 , Ylitalo Antti  68 , João A Brum Silveira  69 , Rodrigo Zoni  70 , Ivan Bessonov  71 , Stefano Savonitto  72 , George Kochiadakis  73 , Dimitrios Alexopoulos  74 , Carlos E Uribe  75 , John Kanakakis  76 , Benjamin Faurie  77 , Gabriele Gabrielli  78 , Alejandro Gutierrez Barrios  79 , Juan Pablo Bachini  80 , Alex Rocha  81 , Frankie Chor-Cheung Tam  82 , Alfredo Rodriguez  83 , Antonia Anna Lukito  84 , Veauthyelau Saint-Joy  85 , Gustavo Pessah  86 , Andrea Tuccillo  16 , Giuliana Cortese  87 , Guido Parodi  88 , Mohamed Abed Bouraghda  89 , Elvin Kedhi  90 , Pablo Lamelas  62 , Harry Suryapranata  91 , Monica Verdoia  92
Affiliations
Multicenter Study

Impact of chronic obstructive pulmonary disease on short-term outcome in patients with ST-elevation myocardial infarction during COVID-19 pandemic: insights from the international multicenter ISACS-STEMI registry

Giuseppe De Luca et al. Respir Res. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclerosis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocardial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study.

Methods: In the ISACS-STEMI COVID-19 registry we included retrospectively patients with STEMI treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 from 109 high-volume primary PCI centers in 4 continents.

Results: A total of 15,686 patients were included in this analysis. Of them, 810 (5.2%) subjects had a COPD diagnosis. They were more often elderly and with a more pronounced cardiovascular risk profile. No preminent procedural dissimilarities were noticed except for a lower proportion of dual antiplatelet therapy at discharge among COPD patients (98.9% vs. 98.1%, P = 0.038). With regards to short-term fatal outcomes, both in-hospital and 30-days mortality occurred more frequently among COPD patients, similarly in pre-COVID-19 and COVID-19 era. However, after adjustment for main baseline differences, COPD did not result as independent predictor for in-hospital death (adjusted OR [95% CI] = 0.913[0.658-1.266], P = 0.585) nor for 30-days mortality (adjusted OR [95% CI] = 0.850 [0.620-1.164], P = 0.310). No significant differences were detected in terms of SARS-CoV-2 positivity between the two groups.

Conclusion: This is one of the largest studies investigating characteristics and outcome of COPD patients with STEMI undergoing primary angioplasty, especially during COVID pandemic. COPD was associated with significantly higher rates of in-hospital and 30-days mortality. However, this association disappeared after adjustment for baseline characteristics. Furthermore, COPD did not significantly affect SARS-CoV-2 positivity.

Trial registration number: NCT04412655 (2nd June 2020).

Keywords: COPD; Mortality; STEMI.

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Conflict of interest statement

All authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

Fig. 1
Fig. 1
Bar graphs show in-hospital (panel A) and 30-day (panel B) mortality in the overall cohort, according to COPD diagnosis. COPD  chronic obstructive pulmonary disease
Fig. 2
Fig. 2
Bar graphs show in-hospital (panel A) and 30-day (panel B) mortality in 2019 and in 2020 cohorts, according to COPD diagnosis. COPD  chronic obstructive pulmonary disease
Fig. 3
Fig. 3
Bar graphs show the impact of SARS-CoV-2 positivity on in-hospital and 30-day mortality in both COPD and non-COPD patients. COPD = chronic obstructive pulmonary disease
See this image and copyright information in PMC

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