Document Detail


Increased adverse events after percutaneous coronary intervention in patients with COPD: insights from the National Heart, Lung, and Blood Institute dynamic registry.
MedLine Citation:
PMID:  21527507     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies have demonstrated that patients with COPD are at higher risk for death after percutaneous coronary intervention (PCI), but other clinical outcomes and possible associations with adverse events have not been described.
METHODS: Using waves 1 through 5 (1999-2006) of the National Heart, Lung, and Blood Institute Dynamic Registry, patients with COPD (n = 860) and without COPD (n = 10,048) were compared. Baseline demographics, angiographic characteristics, and in-hospital and 1-year adverse events were compared.
RESULTS: Patients with COPD were older (mean age 66.8 vs 63.2 years, P < .001), more likely to be women, and more likely to have a history of diabetes, prior myocardial infarction, peripheral arterial disease, renal disease, and smoking. Patients with COPD also had a lower mean ejection fraction (49.1% vs 53.0%, P < .001) and a greater mean number of significant lesions (3.2 vs 3.0, P = .006). Rates of in-hospital death (2.2% vs 1.1%, P = .003) and major entry site complications (6.6% vs 4.2%, P < .001) were higher in pulmonary patients. At discharge, pulmonary patients were significantly less likely to be prescribed aspirin (92.4% vs 95.3%, P < .001), β-blockers (55.7% vs 76.2%, P < .001), and statins (60.0% vs 66.8%, P < .001). After adjustment, patients with COPD had significantly increased risk of death (hazard ratio [HR] = 1.30, 95% CI = 1.01-1.67) and repeat revascularization (HR = 1.22, 95% CI = 1.02-1.46) at 1 year, compared with patients without COPD.
CONCLUSIONS: COPD is associated with higher mortality rates and repeat revascularization within 1 year after PCI. These higher rates of adverse outcomes may be associated with lower rates of guideline-recommended class 1 medications prescribed at discharge.
Authors:
Jonathan R Enriquez; Shailja V Parikh; Faith Selzer; Alice K Jacobs; Oscar Marroquin; Suresh Mulukutla; Vankeepuram Srinivas; Elizabeth M Holper
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-04-28
Journal Detail:
Title:  Chest     Volume:  140     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-07     Completed Date:  2011-12-14     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  604-10     Citation Subset:  AIM; IM    
Affiliation:
University of Texas Southwestern Medical Center, Division of Cardiology, Dallas, TX 75390-8837, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary*
Comorbidity
Coronary Angiography
Coronary Artery Disease / epidemiology*,  therapy*
Female
Hospital Mortality
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / epidemiology
Myocardial Revascularization / statistics & numerical data
National Heart, Lung, and Blood Institute (U.S.)
Outcome Assessment (Health Care)
Pulmonary Disease, Chronic Obstructive / epidemiology*,  mortality,  physiopathology
Registries
Retreatment
Stroke Volume
United States
Grant Support
ID/Acronym/Agency:
HL-33292/HL/NHLBI NIH HHS; U01 HL033292-15/HL/NHLBI NIH HHS; U01 HL033292-16/HL/NHLBI NIH HHS; U01 HL033292-17/HL/NHLBI NIH HHS; U01 HL033292-18/HL/NHLBI NIH HHS; U01 HL033292-19/HL/NHLBI NIH HHS; U01 HL033292-20/HL/NHLBI NIH HHS; U01 HL033292-21/HL/NHLBI NIH HHS; U01 HL033292-22/HL/NHLBI NIH HHS; U01 HL033292-23/HL/NHLBI NIH HHS; U01 HL033292-24/HL/NHLBI NIH HHS; U01 HL033292-25/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Chest. 2012 Feb;141(2):571-2; author reply 572-3   [PMID:  22315128 ]
Chest. 2011 Sep;140(3):569-71   [PMID:  21896514 ]
Chest. 2012 Mar;141(3):828-9; author reply 829   [PMID:  22396574 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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