| Relationship between chronic obstructive pulmonary disease and in-hospital management and outcomes in patients with acute myocardial infarction. | |
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MedLine Citation:
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PMID: 20411453 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Artur Dziewierz; Zbigniew Siudak; Tomasz Rakowski; Michał Brzeziński; Joanna Zdzienicka; Waldemar Mielecki; Jacek S Dubiel; Dariusz Dudek |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Kardiologia polska Volume: 68 ISSN: 0022-9032 ISO Abbreviation: Kardiol Pol Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-04-22 Completed Date: 2010-07-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376352 Medline TA: Kardiol Pol Country: Poland |
Other Details:
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Languages: eng Pagination: 294-301 Citation Subset: IM |
Affiliation:
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2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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50-78-2/Aspirin; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
| Comments/Corrections | |
Comment In:
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Kardiol Pol. 2010 Mar;68(3):302-3
[PMID:
20491181
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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