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Impact of Chronic Obstructive Pulmonary Disease on Long-Term Outcome after ST-segment elevation Myocardial Infarction receiving primary Percutaneous Coronary Intervention.
MedLine Citation:
PMID:  23392738     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT BACKGROUND: there are limited data describing the long-term outcome of patients with concomitant chronic obstructive pulmonary disease (COPD) who develop ST-segment elevation myocardial infarction (STEMI). METHODS: 11,118 consecutive STEMI patients enrolled in the web-based REAL registry (Registro Regionale Angioplastiche Emilia-Romagna) 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 (SB) and COPD were assessed. RESULTS: according to our criteria, 2032 (18.2%) patients had a diagnosis of COPD. Overall, 1829 (16.5%) patients died. COPD was an independent predictor of mortality (HR 1.4, 95%CI 1.2-1.6). Hospital readmissions for recurrent MI (10% vs. 6.9%, p<0.01), for CR (22% vs. 19%, p<0.01), for HF (10% vs. 6.9%, p<0.01) and for SB (10% vs. 6%, p<0.01) were significantly more frequent in patients with COPD as compared to those without. Also hospital readmissions for COPD were more frequent in patients with a previous history of COPD as compared to those without (19% vs. 3%, p<0.01, respectively). Patients with a hospital readmission for COPD showed a 4-fold risk increase 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 (e.g. recurrent MI, HF, bleedings) than patients without COPD.
Authors:
Gianluca Campo; Paolo Guastaroba; Antonio Marzocchi; Andrea Santarelli; Elisabetta Varani; Luigi Vignali; Pietro Sangiorgio; Stefano Tondi; Carlotta Serenelli; Rossana De Palma; Francesco Saia
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-7
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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