COPD has negative prognostic impact in heart attack patients

By Mark Cowen, Senior medwireNews Reporter

Chronic obstructive pulmonary disease (COPD) is associated with an increased risk for death and hospital readmission for cardiovascular causes in patients with ST-segment elevation myocardial infarction (STEMI), research shows.

Gianluca Campo (Azienda Ospedaliero-Universitaria S Anna, Ferrara, Italy) and team found that hospital readmission rates for recurrent MI, heart failure, coronary revascularization, and serious bleeding were significantly higher in STEMI patients with than without COPD.

"Our work confirms the negative prognostic impact of COPD [in STEMI patients] and reinforces the need for continuous attention to be devoted to identifying this high risk group of patients so as to apply timely and effective preventive and treatment strategies," they comment in Chest.

The researchers conducted a 3-year follow-up study of 11,118 patients hospitalized and treated for STEMI between 2003 and 2009. Of these, 2032 (18.2%) had a diagnosis of COPD before hospital admission.

Overall, 1829 (16.5%) patients died during follow up, with mortality significantly higher in patients with than without COPD, at 23.5% versus 16.0. Indeed, COPD was an independent risk factor for death, at a hazard ratio of 1.4.

Compared with patients without COPD, those with the lung condition had significantly higher rates of hospital readmission for recurrent MI (6.6 vs 10.0%), coronary revascularization (19.0 vs 22.0%), heart failure (6.9 vs 10.0%), and serious bleeding (6.0 vs 10.0%).

The researchers also found that hospital readmission for COPD after STEMI was independently associated with a 4.2-fold increased risk for death, a 2.1-fold greater risk for recurrent MI, a 5.8-fold greater risk for heart failure, and a 3.0-fold increased risk for serious bleeding.

Campo and team conclude: "In spite of recent progress in the treatment of cardiac and pulmonary diseases, patients with concomitant COPD admitted to hospital for STEMI remain at increased risk for death and hospital readmissions due to cardiovascular causes (e.g. recurrent MI, heart failure, bleedings) as

compared to patients without COPD as comorbidity."

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