Document Detail


Relationship between chronic obstructive pulmonary disease and in-hospital management and outcomes in patients with acute myocardial infarction.
MedLine Citation:
PMID:  20411453     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with unfavourable short- and long-term outcome in patients with coronary artery disease undergoing revascularisation procedures. AIM: To assess the associations of COPD with in-hospital management and mortality in patients with acute myocardial infarction (MI) admitted to hospitals without on-site invasive facilities. METHODS: We identified 81 (11.3%) patients with COPD and 633 (88.7%) without COPD treated in the Krakow Registry of Acute Coronary Syndromes from February 2005 to March 2005 and from December 2005 to January 2006. Data concerning in-hospital management and mortality were assessed. RESULTS: Patients with COPD were older and were more likely to have prior angina, prior heart failure symptoms, prior stroke, and lower left ventricular ejection fraction. Patients with COPD diagnosis were less likely to be transferred for invasive treatment [COPD (-) vs. COPD (+), 12.3 vs. 34.9%; p < 0.0001] and to receive aspirin and clopidogrel during index hospital stay. In-hospital mortality was higher in patients with COPD diagnosis [COPD (-) vs. COPD (+), 58 of 412 (14.1%) vs. 21 of 71 (29.6%); p = 0.002]. COPD was an independent predictor of in-hospital death in multivariate Cox regression analysis. CONCLUSIONS: Coexistence of COPD with acute MI may be associated with less frequent transfer for invasive treatment, less aggressive pharmacotherapy, and higher in-hospital mortality in patients admitted to community hospitals without on-site invasive facilities. These differences may be partially driven by a higher risk profile of COPD patients.
Authors:
Artur Dziewierz; Zbigniew Siudak; Tomasz Rakowski; Michał Brzeziński; Joanna Zdzienicka; Waldemar Mielecki; Jacek S Dubiel; Dariusz Dudek
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  68     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-22     Completed Date:  2010-07-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  294-301     Citation Subset:  IM    
Affiliation:
2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aspirin / therapeutic use
Comorbidity
Female
Health Services Accessibility / statistics & numerical data*
Hospital Mortality*
Humans
Male
Myocardial Infarction / epidemiology*,  therapy*
Poland / epidemiology
Pulmonary Disease, Chronic Obstructive / epidemiology*
Risk Management / methods*,  organization & administration
Ticlopidine / analogs & derivatives,  therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel
Comments/Corrections
Comment In:
Kardiol Pol. 2010 Mar;68(3):302-3   [PMID:  20491181 ]

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