Increased adverse events after percutaneous coronary intervention in patients with COPD: insights from the National Heart, Lung, and Blood Institute dynamic registry.

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
Related Documents :	16938717 - Small-bowel permeability in collagenous colitis. 8421137 - Subclinical celiac sprue. increasing occurrence and clues to its diagnosis. 10695607 - Improved screening for intestinal villous atrophy by d-xylose breath test. 1300607 - Neurofibromatosis involving the small bowel associated with adenocarcinoma of the ileum... 10502967 - The comparison of the incidence of horseshoe kidney in autopsy cases versus urologic pa... 22517997 - Clinical and mri investigation of temporomandibular joint in major depressed patients.
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: 2012-10-19
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.
Export Citation:	APA/MLA Format Download EndNote Download BibTex
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 Mar;141(3):828-9; author reply 829 [PMID: 22396574 ] Chest. 2011 Sep;140(3):569-71 [PMID: 21896514 ] Chest. 2012 Feb;141(2):571-2; author reply 572-3 [PMID: 22315128 ]

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

Previous Document: Multigene mutation analysis of metastatic lymph nodes in non-small cell lung cancer diagnosed by end...
Next Document: Atelectasis as a cause of postoperative fever: where is the clinical evidence?