Tags

Type your tag names separated by a space and hit enter

Underdiagnosis and prognosis of chronic obstructive pulmonary disease after percutaneous coronary intervention: a prospective study.
Int J Chron Obstruct Pulmon Dis. 2015; 10:1353-61.IJ

Abstract

BACKGROUND

Retrospective studies based on clinical data and without spirometric confirmation suggest a poorer prognosis of patients with ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) following percutaneous coronary intervention (PCI). The impact of undiagnosed COPD in these patients is unknown. We aimed to evaluate the prognostic impact of COPD - previously or newly diagnosed - in patients with IHD treated with PCI.

METHODS

Patients with IHD confirmed by PCI were consecutively included. After PCI they underwent forced spirometry and evaluation for cardiovascular risk factors. All-cause mortality, new cardiovascular events, and their combined endpoint were analyzed.

RESULTS

A total of 133 patients (78%) male, with a mean (SD) age of 63 (10.12) years were included. Of these, 33 (24.8%) met the spirometric criteria for COPD, of whom 81.8% were undiagnosed. IHD patients with COPD were older, had more coronary vessels affected, and a greater history of previous myocardial infarction. Median follow-up was 934 days (interquartile range [25%-75%]: 546-1,160). COPD patients had greater mortality (P=0.008; hazard ratio [HR]: 8.85; 95% confidence interval [CI]: 1.76-44.47) and number of cardiovascular events (P=0.024; HR: 1.87; 95% CI: 1.04-3.33), even those without a previous diagnosis of COPD (P=0.01; HR: 1.78; 95% CI: 1.12-2.83). These differences remained after adjustment for sex, age, number of coronary vessels affected, and previous myocardial infarction (P=0.025; HR: 1.83; 95% CI: 1.08-3.1).

CONCLUSION

Prevalence and underdiagnosis of COPD in patients with IHD who undergo PCI are both high. These patients have an independent greater mortality and a higher number of cardiovascular events during follow-up.

Authors+Show Affiliations

Department of Internal Medicine, Mutua de Terrassa University Hospital, Terrassa, Spain.Pneumology Service, Mutua de Terrassa University Hospital, Terrassa, Spain.Department of Internal Medicine, Mutua de Terrassa University Hospital, Terrassa, Spain.Department of Internal Medicine, Mutua de Terrassa University Hospital, Terrassa, Spain.Medical Department, Menarini Pharmaceutical, Barcelona, Spain.Cardiology Service, Mutua de Terrassa University Hospital, Terrassa, Spain.Pneumology Service, Mutua de Terrassa University Hospital, Terrassa, Spain.Department of Internal Medicine, Mutua de Terrassa University Hospital, Terrassa, Spain.Instituto de Investigación Sanitaria Princesa (IP), Universidad Autónoma de Madrid, Madrid, Spain.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26213464

Citation

Almagro, Pere, et al. "Underdiagnosis and Prognosis of Chronic Obstructive Pulmonary Disease After Percutaneous Coronary Intervention: a Prospective Study." International Journal of Chronic Obstructive Pulmonary Disease, vol. 10, 2015, pp. 1353-61.
Almagro P, Lapuente A, Pareja J, et al. Underdiagnosis and prognosis of chronic obstructive pulmonary disease after percutaneous coronary intervention: a prospective study. Int J Chron Obstruct Pulmon Dis. 2015;10:1353-61.
Almagro, P., Lapuente, A., Pareja, J., Yun, S., Garcia, M. E., Padilla, F., Heredia, J. L., De la Sierra, A., & Soriano, J. B. (2015). Underdiagnosis and prognosis of chronic obstructive pulmonary disease after percutaneous coronary intervention: a prospective study. International Journal of Chronic Obstructive Pulmonary Disease, 10, 1353-61. https://doi.org/10.2147/COPD.S84482
Almagro P, et al. Underdiagnosis and Prognosis of Chronic Obstructive Pulmonary Disease After Percutaneous Coronary Intervention: a Prospective Study. Int J Chron Obstruct Pulmon Dis. 2015;10:1353-61. PubMed PMID: 26213464.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Underdiagnosis and prognosis of chronic obstructive pulmonary disease after percutaneous coronary intervention: a prospective study. AU - Almagro,Pere, AU - Lapuente,Anna, AU - Pareja,Julia, AU - Yun,Sergi, AU - Garcia,Maria Estela, AU - Padilla,Ferrán, AU - Heredia,Josep L I, AU - De la Sierra,Alex, AU - Soriano,Joan B, Y1 - 2015/07/16/ PY - 2015/7/28/entrez PY - 2015/7/28/pubmed PY - 2016/4/26/medline KW - ischemic heart disease KW - mortality KW - myocardial infarction KW - prognosis SP - 1353 EP - 61 JF - International journal of chronic obstructive pulmonary disease JO - Int J Chron Obstruct Pulmon Dis VL - 10 N2 - BACKGROUND: Retrospective studies based on clinical data and without spirometric confirmation suggest a poorer prognosis of patients with ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) following percutaneous coronary intervention (PCI). The impact of undiagnosed COPD in these patients is unknown. We aimed to evaluate the prognostic impact of COPD - previously or newly diagnosed - in patients with IHD treated with PCI. METHODS: Patients with IHD confirmed by PCI were consecutively included. After PCI they underwent forced spirometry and evaluation for cardiovascular risk factors. All-cause mortality, new cardiovascular events, and their combined endpoint were analyzed. RESULTS: A total of 133 patients (78%) male, with a mean (SD) age of 63 (10.12) years were included. Of these, 33 (24.8%) met the spirometric criteria for COPD, of whom 81.8% were undiagnosed. IHD patients with COPD were older, had more coronary vessels affected, and a greater history of previous myocardial infarction. Median follow-up was 934 days (interquartile range [25%-75%]: 546-1,160). COPD patients had greater mortality (P=0.008; hazard ratio [HR]: 8.85; 95% confidence interval [CI]: 1.76-44.47) and number of cardiovascular events (P=0.024; HR: 1.87; 95% CI: 1.04-3.33), even those without a previous diagnosis of COPD (P=0.01; HR: 1.78; 95% CI: 1.12-2.83). These differences remained after adjustment for sex, age, number of coronary vessels affected, and previous myocardial infarction (P=0.025; HR: 1.83; 95% CI: 1.08-3.1). CONCLUSION: Prevalence and underdiagnosis of COPD in patients with IHD who undergo PCI are both high. These patients have an independent greater mortality and a higher number of cardiovascular events during follow-up. SN - 1178-2005 UR - https://www.unboundmedicine.com/medline/citation/26213464/Underdiagnosis_and_prognosis_of_chronic_obstructive_pulmonary_disease_after_percutaneous_coronary_intervention:_a_prospective_study_ L2 - https://dx.doi.org/10.2147/COPD.S84482 DB - PRIME DP - Unbound Medicine ER -