Effects of chronic obstructive pulmonary disease on longterm prognosis of patients with coronary heart disease postpercutaneous coronary intervention

摘要

BACKGROUND Chronic obstructive pulmonary disease(COPD)and cardiovascular diseases are often comorbid conditions,their co-occurrence yields worse outcomes than either condition alone.This study aimed to investigate COPD impacts on the five-year prognosis of patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).METHODS Patients with CHD who underwent PCI in 2013 were recruited,and divided into COPD group and non-COPD group.Adverse events occurring among those groups were recorded during the five-year follow-up period after PCI,including all-cause death and cardiogenic death,myocardial infarction,repeated revascularization,as well as stroke and bleeding events.Major adverse cardiac and cerebral events were a composite of all-cause death,myocardial infarction,repeated revascularization and stroke.RESULTS A total of 9843 patients were consecutively enrolled,of which 229 patients(2.3%)had COPD.Compared to non-COPD patients,COPD patients were older,along with poorer estimated glomerular filtration rate and lower left ventricular ejection fraction.Five-year follow-up results showed that incidences of all-cause death and cardiogenic death,as well as major adverse cardiac and cerebral events,for the COPD group were significantly higher than for non-COPD group(10.5%vs.3.9%,7.4%vs.2.3%,and 30.1%vs.22.6%,respectively).COPD was found under multivariate Cox regression analysis,adjusted for confounding factors,to be an independent predictor of all-cause death[odds ratio(OR)=1.76,95%CI:1.15-2.70,P=0.009]and cardiogenic death(OR=2.02,95%CI:1.21-3.39,P=0.007).CONCLUSIONS COPD is an independent predictive factor for clinical mortality,in which CHD patients with COPD are associated with worse prognosis than CHD patients with non-COPD.