Prevalence and Prognosis of Chronic Obstructive Pulmonary Disease Among 8167 Middle Eastern Patients With Acute Coronary Syndrome
Open Access
- 8 April 2010
- journal article
- research article
- Published by Wiley in Clinical Cardiology
- Vol. 33 (4), 228-235
- https://doi.org/10.1002/clc.20751
Abstract
Background The purpose of this study was to report the prevalence and the significance of clinically recognized chronic obstructive pulmonary disease (COPD) during acute coronary syndrome (ACS). Hypothesis COPD in patients with ACS is associated with worse outcome. Methods Data were derived from a prospective, multicenter, multinational study of 8167 consecutive patients hospitalized with ACS from February to June 2007 in 6 Middle Eastern countries. Data were analyzed according to the presence or absence of COPD. Demographic, management, and in‐hospital outcomes were compared. Results The prevalence of COPD was 5.3%. When compared with non‐COPD patients, COPD patients were older and more likely to have diabetes, hypertension, and dyslipidemia. Atypical presentations were more common in COPD patients (P = 0.001). COPD patients were less likely to be treated with thrombolytic therapy (P = 0.001), β‐blockers (P = 0.001), and glycoprotein IIb/IIIa inhibitors, and more likely to receive angiotensin‐converting enzyme (ACE) inhibitors. Although there was no difference in in‐hospital mortality between the 2 groups, patients with COPD were more likely to have heart failure (P = 0.001). Despite the fact that COPD patients with ST‐segment elevation myocardial infarction were less likely to receive thrombolytic therapy, they suffered more bleeding complications (2.8% vs 1%, P = 0.04), resulting in prolonged hospitalization. COPD was not an independent predictor of increased in‐hospital mortality. Conclusions In this large cohort of patients with ACS, the prevalence of COPD was 5·3%. Atypical presentation is common among COPD patients, and this may result in delayed therapy. ACS in COPD patients was associated with higher risk of heart failure and major bleeding complications without increased risk of in‐hospital mortality. CopyrightKeywords
This publication has 39 references indexed in Scilit:
- Cardiovascular Disease in Patients with Chronic Obstructive Pulmonary Disease, Saskatchewan Canada: Cardiovascular Disease in COPD PatientsAnnals of Epidemiology, 2006
- COPD and Incident Cardiovascular Disease Hospitalizations and Mortality: Kaiser Permanente Medical Care ProgramSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2005
- Trends and Cardiovascular Co-morbidities of COPD Patients in the Veterans Administration Medical System, 1991–1999COPD: Journal of Chronic Obstructive Pulmonary Disease, 2005
- Why Are Patients With Chronic Obstructive Pulmonary Disease at Increased Risk of Cardiovascular Diseases?Circulation, 2003
- Co-morbidity contributes to predict mortality of patients with chronic obstructive pulmonary diseaseEuropean Respiratory Journal, 1997
- Relationships between Ischemic Heart Disease and Chronic Diffuse Pulmonary DiseaseSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1971
- Myocardial Infarction in Pulmonary EmphysemaDiseases of the Chest, 1965
- THE RECOGNITION OF CORONARY HEART DISEASE IN THE PRESENCE OF PULMONARY DISEASEHeart, 1964
- Myocardial Infarction in Respiratory InsufficiencyArchives of Internal Medicine, 1964
- CORONARY HEART DISEASE IN THE PRESENCE OF PULMONARY DISEASEHeart, 1958