BACKGROUND: Although chronic lung disease (CLD) is common among patients with myocardial infarction (MI), little is known about the influence of CLD on patient management and outcomes following MI. METHODS: Using the National Cardiovascular Data Registry's ACTION Registry-GWTG, demographics, clinical characteristics, treatments, processes of care, and in-hospital adverse events after acute MI were compared between patients with (n = 22,624) and without (n = 136,266) CLD. Multivariable adjustment was performed to determine the independent association of CLD with treatments and adverse events. RESULTS: CLD (17.0% of non-ST-elevation MI [NSTEMI] and 10.1% of ST-elevation MI [STEMI] patients) was associated with older age, female sex, and a greater burden of comorbidities. Among NSTEMI patients, those with CLD were less likely to undergo cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft compared to those without; in contrast, no differences were seen in invasive therapies for STEMI patients with or without CLD. Multivariable-adjusted risk of major bleeding was significantly increased in CLD patients with NSTEMI (13.0% vs 8.1%, OR(adj) = 1.27, 95% CI = 1.20-1.34, P < .001) and STEMI (16.0% vs 10.5%, OR(adj) = 1.19, 95% CI = 1.10-1.29, P < .001). In NSTEMI, CLD was associated with a higher risk of inhospital mortality (OR(adj) = 1.21, 95% CI = 1.11-1.33); in STEMI no association between CLD and mortality was seen (OR(adj) = 1.05, 95% CI = 0.95-1.17). CONCLUSIONS: CLD is common among patients with MI and is independently associated with an increased risk for major bleeding. In NSTEMI, CLD is also associated with receiving less revascularization and with increased in-hospital mortality. Special attention should be given to this high-risk subgroup for the prevention and management of complications after MI.
BACKGROUND: Although chronic lung disease (CLD) is common among patients with myocardial infarction (MI), little is known about the influence of CLD on patient management and outcomes following MI. METHODS: Using the National Cardiovascular Data Registry's ACTION Registry-GWTG, demographics, clinical characteristics, treatments, processes of care, and in-hospital adverse events after acute MI were compared between patients with (n = 22,624) and without (n = 136,266) CLD. Multivariable adjustment was performed to determine the independent association of CLD with treatments and adverse events. RESULTS: CLD (17.0% of non-ST-elevation MI [NSTEMI] and 10.1% of ST-elevation MI [STEMI] patients) was associated with older age, female sex, and a greater burden of comorbidities. Among NSTEMI patients, those with CLD were less likely to undergo cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass graft compared to those without; in contrast, no differences were seen in invasive therapies for STEMI patients with or without CLD. Multivariable-adjusted risk of major bleeding was significantly increased in CLD patients with NSTEMI (13.0% vs 8.1%, OR(adj) = 1.27, 95% CI = 1.20-1.34, P < .001) and STEMI (16.0% vs 10.5%, OR(adj) = 1.19, 95% CI = 1.10-1.29, P < .001). In NSTEMI, CLD was associated with a higher risk of inhospital mortality (OR(adj) = 1.21, 95% CI = 1.11-1.33); in STEMI no association between CLD and mortality was seen (OR(adj) = 1.05, 95% CI = 0.95-1.17). CONCLUSIONS: CLD is common among patients with MI and is independently associated with an increased risk for major bleeding. In NSTEMI, CLD is also associated with receiving less revascularization and with increased in-hospital mortality. Special attention should be given to this high-risk subgroup for the prevention and management of complications after MI.
Authors: Randi E Foraker; Avirup Guha; Henry Chang; Emily C O'Brien; Julie K Bower; Elliott D Crouser; Wayne D Rosamond; Subha V Raman Journal: Glob Heart Date: 2018-03-05
Authors: Alexander C Fanaroff; Matthew T Roe; Robert M Clare; Yuliya Lokhnygina; Ann Marie Navar; Robert P Giugliano; Stephen D Wiviott; Andrew M Tershakovec; Eugene Braunwald; Michael A Blazing Journal: J Am Heart Assoc Date: 2017-09-18 Impact factor: 5.501
Authors: Julian Grebe; Tobias Müller; Ertunc Altiok; Michael Becker; András P Keszei; Nikolaus Marx; Michael Dreher; Ayham Daher Journal: J Clin Med Date: 2022-03-30 Impact factor: 4.241
Authors: Giuseppe De Luca; Matteo Nardin; Magdy Algowhary; Berat Uguz; Dinaldo C Oliveira; Vladimir Ganyukov; Zan Zimbakov; Miha Cercek; Lisette Okkels Jensen; Poay Huan Loh; Lucian Calmac; Gerard Roura Ferrer; Alexandre Quadros; Marek Milewski; Fortunato Scotto di Uccio; Clemens von Birgelen; Francesco Versaci; Jurrien Ten Berg; Gianni Casella; Aaron Wong Sung Lung; Petr Kala; José Luis Díez Gil; Xavier Carrillo; Maurits Dirksen; Victor M Becerra-Munoz; Michael Kang-Yin Lee; Dafsah Arifa Juzar; Rodrigo de Moura Joaquim; Roberto Paladino; Davor Milicic; Periklis Davlouros; Nikola Bakraceski; Filippo Zilio; Luca Donazzan; Adriaan Kraaijeveld; Gennaro Galasso; Arpad Lux; Lucia Marinucci; Vincenzo Guiducci; Maurizio Menichelli; Alessandra Scoccia; Aylin Hatice Yamac; Kadir Ugur Mert; Xacobe Flores Rios; Tomas Kovarnik; Michal Kidawa; Josè Moreu; Vincent Flavien; Enrico Fabris; Iñigo Lozano Martínez-Luengas; Marco Boccalatte; Francisco Bosa Ojeda; Carlos Arellano-Serrano; Gianluca Caiazzo; Giuseppe Cirrincione; Hsien-Li Kao; Juan Sanchis Forés; Luigi Vignali; Helder Pereira; Stephane Manzo; Santiago Ordoñez; Alev Arat Özkan; Bruno Scheller; Heidi Lehtola; Rui Teles; Christos Mantis; Ylitalo Antti; João A Brum Silveira; Rodrigo Zoni; Ivan Bessonov; Stefano Savonitto; George Kochiadakis; Dimitrios Alexopoulos; Carlos E Uribe; John Kanakakis; Benjamin Faurie; Gabriele Gabrielli; Alejandro Gutierrez Barrios; Juan Pablo Bachini; Alex Rocha; Frankie Chor-Cheung Tam; Alfredo Rodriguez; Antonia Anna Lukito; Veauthyelau Saint-Joy; Gustavo Pessah; Andrea Tuccillo; Giuliana Cortese; Guido Parodi; Mohamed Abed Bouraghda; Elvin Kedhi; Pablo Lamelas; Harry Suryapranata; Monica Verdoia Journal: Respir Res Date: 2022-08-15