Gianluca Campo1, Paolo Guastaroba2, Antonio Marzocchi3, Andrea Santarelli4, Elisabetta Varani5, Luigi Vignali6, Pietro Sangiorgio7, Stefano Tondi8, Carlotta Serenelli9, Rossana De Palma2, Francesco Saia3. 1. Cardiovascular Institute, Azienda Ospedaliero-Universitaria S.Anna, Ferrara; LTTA center, Ferrara. Electronic address: cmpglc@unife.it. 2. Agenzia Sanitaria Regionale Regione Emilia-Romagna, Bologna. 3. Istituto di Cardiologia, Università di Bologna, Policlinico S. Orsola-Malpighi, Bologna. 4. Unità Operativa di Cardiologia, Ospedale degli Infermi, Rimini. 5. Unità Operativa di Cardiologia, Ospedale S. Maria delle Croci, Ravenna. 6. Divisione di Cardiologia, Ospedale Maggiore, Parma. 7. Unità Operativa di Cardiologia, Ospedale Maggiore, Bologna. 8. Unità Operativa di Cardiologia, Ospedale di Baggiovara, Modena. 9. Dipartimento Cure Primarie, Azienda Sanitaria Locale di Ferrara, Ferrara, Italy.
Abstract
BACKGROUND: There are limited data describing the long-term outcome of patients with concomitant COPD who develop ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 11,118 consecutive patients with STEMI enrolled in the web-based Registro Regionale Angioplastiche Emilia-Romagna (REAL) registry were followed-up and stratified according to COPD presence or not. At 3-year follow-up, mortality and hospital readmissions due to myocardial infarction (MI), heart failure (HF), coronary revascularization (CR), serious bleeding, and COPD were assessed. RESULTS: According to our criteria, 2,032 patients (18.2%) had a diagnosis of COPD. Overall, 1,829 patients (16.5%) died. COPD was an independent predictor of mortality (hazard ratio [HR], 1.4; 95% CI, 1.2-1.6). Hospital readmissions for recurrent MI (10% vs 6.9%, P < .01), CR (22% vs 19%, P < .01), HF (10% vs 6.9%, P < .01), and SB (10% vs 6%, P < .01) were significantly more frequent in patients with COPD as compared with those without. Also, hospital readmissions for COPD were more frequent in patients with a previous history of COPD as compared with those without (19% vs 3%; P < .01, respectively). Patients with a hospital readmission for COPD showed a fourfold increased risk of death (HR, 4.2; 95% CI, 3.4-5.2). Finally, hospital readmissions for COPD emerged as a strong independent risk factor for recurrence of MI (HR, 2.1; 95% CI, 1.4-3.3), HF (HR, 5.8; 95% CI, 4.6-7.5), and SB (HR, 3; 95% CI, 2.1-4.4). CONCLUSIONS: Patients with STEMI and concomitant COPD are at greater risk for death and hospital readmissions due to cardiovascular causes (eg, recurrent MI, HF, bleedings) than patients without COPD.
BACKGROUND: There are limited data describing the long-term outcome of patients with concomitant COPD who develop ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 11,118 consecutive patients with STEMI enrolled in the web-based Registro Regionale Angioplastiche Emilia-Romagna (REAL) registry were followed-up and stratified according to COPD presence or not. At 3-year follow-up, mortality and hospital readmissions due to myocardial infarction (MI), heart failure (HF), coronary revascularization (CR), serious bleeding, and COPD were assessed. RESULTS: According to our criteria, 2,032 patients (18.2%) had a diagnosis of COPD. Overall, 1,829 patients (16.5%) died. COPD was an independent predictor of mortality (hazard ratio [HR], 1.4; 95% CI, 1.2-1.6). Hospital readmissions for recurrent MI (10% vs 6.9%, P &lt; .01), CR (22% vs 19%, P &lt; .01), HF (10% vs 6.9%, P &lt; .01), and SB (10% vs 6%, P &lt; .01) were significantly more frequent in patients with COPD as compared with those without. Also, hospital readmissions for COPD were more frequent in patients with a previous history of COPD as compared with those without (19% vs 3%; P &lt; .01, respectively). Patients with a hospital readmission for COPD showed a fourfold increased risk of death (HR, 4.2; 95% CI, 3.4-5.2). Finally, hospital readmissions for COPD emerged as a strong independent risk factor for recurrence of MI (HR, 2.1; 95% CI, 1.4-3.3), HF (HR, 5.8; 95% CI, 4.6-7.5), and SB (HR, 3; 95% CI, 2.1-4.4). CONCLUSIONS:Patients with STEMI and concomitant COPD are at greater risk for death and hospital readmissions due to cardiovascular causes (eg, recurrent MI, HF, bleedings) than patients without COPD.
Authors: Klaus Distelmaier; Alexander Niessner; Dominik Haider; Irene M Lang; Gottfried Heinz; Gerald Maurer; Herbert Koinig; Barbara Steinlechner; Georg Goliasch Journal: Intensive Care Med Date: 2013-04-24 Impact factor: 17.440
Authors: Pere Almagro; Anna Lapuente; Julia Pareja; Sergi Yun; Maria Estela Garcia; Ferrán Padilla; Josep L I Heredia; Alex De la Sierra; Joan B Soriano Journal: Int J Chron Obstruct Pulmon Dis Date: 2015-07-16