Abstract: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 diseas… Show more
“…Despite adjusting for multiple risk factors that may potentially affect clinical outcomes, COPD still remained an independent predictor of long-term cardiovascular events. Our results also showed that the patients with COPD were older and had an increased prevalence of cardiovascular risk factors, which were consistent with previous studies [14–16]. …”
Section: Discussionsupporting
confidence: 93%
“…The impact of COPD on long-term mortality has been previously investigated. However, most of these studies focused on mortality, but other outcomes such as HF, revascularization, and stroke were not more studied [14, 15]. The present study involved 2362 patients who underwent PCI with diagnosis of COPD confirmed by review of medical records.…”
Objective. The aim of this study was to investigate the association between COPD and major adverse cardiovascular and cerebral events (MACCE) in patients undergoing percutaneous coronary intervention (PCI). Methods. 2,362 patients who underwent PCI were included in this study. Subjects were divided into 2 groups: with COPD (n = 233) and without COPD (n = 2,129). Cox proportional hazards models were analyzed to determine the effect of COPD on the incidence of MACCE. Results. The patients with COPD were older (P < 0.0001) and were more likely to be current smokers (P = 0.02) and have had hypertension (P = 0.02) and diabetes mellitus (P = 0.01). Prevalence of serious cardiovascular comorbidity was higher in the patients with COPD, including a history of MI (P = 0.02) and HF (P < 0.0001). Compared with non-COPD group, the COPD group showed a higher risk of all-cause death (hazard ratio (HR): 2.45, P < 0.0001), cardiac death (HR: 2.53, P = 0.0002), MI (HR: 1.387, P = 0.027), and HF (HR: 2.25, P < 0.0001). Conclusions. Patients with CAD and concomitant COPD are associated with a higher incidence of MACCE (all-cause death, cardiac death, MI, and HF) compared to patients without COPD. The patients with a history of COPD have higher in-hospital and long-term mortality rates than those without COPD after PCI.
“…Despite adjusting for multiple risk factors that may potentially affect clinical outcomes, COPD still remained an independent predictor of long-term cardiovascular events. Our results also showed that the patients with COPD were older and had an increased prevalence of cardiovascular risk factors, which were consistent with previous studies [14–16]. …”
Section: Discussionsupporting
confidence: 93%
“…The impact of COPD on long-term mortality has been previously investigated. However, most of these studies focused on mortality, but other outcomes such as HF, revascularization, and stroke were not more studied [14, 15]. The present study involved 2362 patients who underwent PCI with diagnosis of COPD confirmed by review of medical records.…”
Objective. The aim of this study was to investigate the association between COPD and major adverse cardiovascular and cerebral events (MACCE) in patients undergoing percutaneous coronary intervention (PCI). Methods. 2,362 patients who underwent PCI were included in this study. Subjects were divided into 2 groups: with COPD (n = 233) and without COPD (n = 2,129). Cox proportional hazards models were analyzed to determine the effect of COPD on the incidence of MACCE. Results. The patients with COPD were older (P < 0.0001) and were more likely to be current smokers (P = 0.02) and have had hypertension (P = 0.02) and diabetes mellitus (P = 0.01). Prevalence of serious cardiovascular comorbidity was higher in the patients with COPD, including a history of MI (P = 0.02) and HF (P < 0.0001). Compared with non-COPD group, the COPD group showed a higher risk of all-cause death (hazard ratio (HR): 2.45, P < 0.0001), cardiac death (HR: 2.53, P = 0.0002), MI (HR: 1.387, P = 0.027), and HF (HR: 2.25, P < 0.0001). Conclusions. Patients with CAD and concomitant COPD are associated with a higher incidence of MACCE (all-cause death, cardiac death, MI, and HF) compared to patients without COPD. The patients with a history of COPD have higher in-hospital and long-term mortality rates than those without COPD after PCI.
“…15 Studies utilizing invasive assessments have mostly consisted of retrospective analysis of angiographic data in patients undergoing coronary angiography based on clinical suspicion of disease. 13,16,17 …”
BACKGROUND
Coronary artery disease is a potentially treatable comorbidity observed frequently in both chronic obstructive pulmonary disease and interstitial lung disease. The prevalence of angiographically proven coronary artery disease in advanced lung disease is not well described. We sought to characterize the treatment patterns of coronary artery disease complicating advanced lung disease and to describe the frequency of occult coronary artery disease in this population.
METHODS
We performed a 2-center, retrospective cross-sectional study of patients with either chronic obstructive pulmonary disease or interstitial lung disease evaluated for lung transplantation. Medications and diagnoses before the transplant evaluation were recorded in conjunction with left heart catheterization results.
RESULTS
Of 473 subjects, 351 had chronic obstructive pulmonary disease, and 122 had interstitial lung disease. In subjects diagnosed clinically with coronary artery disease, medical regimens included a statin in 78%, antiplatelet therapy in 62%, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in 42%, and a beta-blocker in 37%. Ten percent were on no medication from these 4 classes. Fifty-seven percent of these subjects were on an antiplatelet agent as well as a statin, and 13% were on neither. Beta-blockers were less frequently prescribed in chronic obstructive pulmonary disease than interstitial lung disease (23% vs 58%, P = .007). Coronary angiography was available in 322 subjects. It demonstrated coronary artery disease in 60% of subjects, and severe coronary artery disease in 16%. Occult coronary artery disease and severe occult coronary artery disease were found in 53% and 9%, respectively. There were no significant differences in angiographic results between chronic obstructive pulmonary disease and interstitial lung disease, despite imbalanced risk factors.
CONCLUSIONS
Coronary artery disease is common in patients with advanced lung disease attributable to chronic obstructive pulmonary disease or interstitial lung disease and is under-diagnosed. Guideline-recommended cardioprotective medications are suboptimally utilized in this population.
“…Further articles were deselected since they were either case studies (2), letter to editors (1), they did not report the relevant endpoints (3), they were duplicates (8) or they were associated with the same trial or cohort (2). Finally, 10 studies [3, 4, 8–15] were selected for this analysis.Fig. 1Flow diagram representing the study selection
…”
BackgroundWe aimed to systematically compare Major Adverse Cardiac Events (MACEs) and mortality following Percutaneous Coronary Intervention (PCI) in patients with and without Chronic Obstructive Pulmonary Diseases (COPD) through a meta-analysis.MethodsElectronic databases (Cochrane library, EMBASE and Medline/PubMed) were searched for English publications comparing in-hospital and long-term MACEs and mortality following PCI in patients with a past medical history of COPD. Statistical analysis was carried out by Revman 5.3 whereby Odds Ratio (OR) and 95% Confidence Intervals (CI) were considered the relevant parameters.ResultsA total number of 72,969 patients were included (7518 patients with COPD and 65,451 patients without COPD). Results of this analysis showed that in-hospital MACEs were significantly higher in the COPD group with OR: 1.40, 95% CI: 1.19–1.65; P = 0.0001, I2 = 0%. Long-term MACEs were still significantly higher in the COPD group with OR: 1.58, 95% CI: 1.38–1.81; P = 0.00001, I2 = 29%. Similarly, in-hospital and long-term mortality were significantly higher in patients with COPD, with OR: 2.25, 95% CI: 1.78–2.85; P = 0.00001, I2 = 0% and OR: 2.22, 95% CI: 1.33–3.71; P = 0.002, I2 = 97% respectively. However, the result for the long-term death was highly heterogeneous.ConclusionSince in-hospital and long-term MACEs and mortality were significantly higher following PCI in patients with versus without COPD, COPD should be considered a risk factor for the development of adverse clinical outcomes following PCI. However, the result for the long-term mortality was highly heterogeneous warranting further analysis.
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