Karsten Keller1, Lukas Hobohm2, Thomas Münzel3, Mir Abolfazl Ostad4, Christine Espinola-Klein4. 1. Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany; Department of Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany. Electronic address: Karsten.Keller@unimedizin-mainz.de. 2. Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany; Department of Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany. 3. Department of Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany. 4. Department of Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.
Abstract
BACKGROUND: Peripheral artery disease (PAD) and chronic obstructive pulmonary disease (COPD) are both related with high in-hospital mortality. We aimed to investigate the impact of COPD on the in-hospital outcomes in PAD. METHODS: PAD patients were selected based on ICD-code I70.2 of the German nationwide database, stratified for COPD and compared regarding adverse in-hospital outcomes. RESULTS: Between 01/2005-12/2015, 5,611,827 inpatients (64.8% males) were diagnosed with PAD; of those, 13.6% were coded additionally with COPD. Overall, 277,894 PAD patients (5.0%) died during in-hospital course. Prevalence of cardiovascular diseases as well as cancer (12.1% vs. 7.0%, P < 0.001) was higher in PAD patients with COPD compared to PAD patients without COPD. PAD patients with COPD showed more often lower PAD stages according to Fontaine classification (PAD stage I: 27.1% vs. 19.3%, P < 0.001; PAD stage IIa: 34.9% vs. 35.5%, P < 0.001; PAD stage IIb: 14.5% vs. 13.6%, P < 0.001; PAD stage III: 11.8% vs. 14.8%, P < 0.001; PAD stage IV: 13.8% vs. 19.6%, P < 0.001). The all-cause in-hospital mortality was significantly higher in PAD patients with COPD compared to those without COPD (6.5% vs. 4.7%, P < 0.001). Cardiovascular events comprising pulmonary embolism and myocardial infarction occurred more often in coprevalence with PAD and COPD. COPD was an independent predictor of in-hospital death (OR 1.16 (95%CI 1.15-1.17) P < 0.001) and an independent predictor for pulmonary embolism (PE, OR 1.44 (1.40-1.49), P < 0.001) in PAD patients. CONCLUSION: COPD was associated with a high in-hospital mortality in PAD patients probably driven by higher frequencies of PE and cancer.
BACKGROUND:Peripheral artery disease (PAD) and chronic obstructive pulmonary disease (COPD) are both related with high in-hospital mortality. We aimed to investigate the impact of COPD on the in-hospital outcomes in PAD. METHODS: PAD patients were selected based on ICD-code I70.2 of the German nationwide database, stratified for COPD and compared regarding adverse in-hospital outcomes. RESULTS: Between 01/2005-12/2015, 5,611,827 inpatients (64.8% males) were diagnosed with PAD; of those, 13.6% were coded additionally with COPD. Overall, 277,894 PAD patients (5.0%) died during in-hospital course. Prevalence of cardiovascular diseases as well as cancer (12.1% vs. 7.0%, P < 0.001) was higher in PAD patients with COPD compared to PAD patients without COPD. PAD patients with COPD showed more often lower PAD stages according to Fontaine classification (PAD stage I: 27.1% vs. 19.3%, P < 0.001; PAD stage IIa: 34.9% vs. 35.5%, P < 0.001; PAD stage IIb: 14.5% vs. 13.6%, P < 0.001; PAD stage III: 11.8% vs. 14.8%, P < 0.001; PAD stage IV: 13.8% vs. 19.6%, P < 0.001). The all-cause in-hospital mortality was significantly higher in PAD patients with COPD compared to those without COPD (6.5% vs. 4.7%, P < 0.001). Cardiovascular events comprising pulmonary embolism and myocardial infarction occurred more often in coprevalence with PAD and COPD. COPD was an independent predictor of in-hospital death (OR 1.16 (95%CI 1.15-1.17) P < 0.001) and an independent predictor for pulmonary embolism (PE, OR 1.44 (1.40-1.49), P < 0.001) in PAD patients. CONCLUSION: COPD was associated with a high in-hospital mortality in PAD patients probably driven by higher frequencies of PE and cancer.