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Original Research: COPD |

Impact of COPD on Long-term Outcome After ST-Segment Elevation Myocardial Infarction Receiving Primary Percutaneous Coronary InterventionCOPD and Outcome After Myocardial Infarction

Gianluca Campo, MD; Paolo Guastaroba, MSc; Antonio Marzocchi, MD; Andrea Santarelli, MD; Elisabetta Varani, MD; Luigi Vignali, MD; Pietro Sangiorgio, MD; Stefano Tondi, MD; Carlotta Serenelli, MD; Rossana De Palma, MD; Francesco Saia, MD, PhD
Author and Funding Information

From the Cardiovascular Institute (Dr Campo), Azienda Ospedaliero-Universitaria S.Anna, Ferrara; LTTA center (Dr Campo), Ferrara; the Agenzia Sanitaria Regionale Regione Emilia-Romagna (Mr Guastaroba and Dr De Palma), Bologna; the Istituto di Cardiologia (Drs Marzocchi and Saia), Università di Bologna, Policlinico S. Orsola-Malpighi, Bologna; the Unità Operativa di Cardiologia (Dr Santarelli), Ospedale degli Infermi, Rimini; the Unità Operativa di Cardiologia (Dr Varani), Ospedale S. Maria delle Croci, Ravenna; the Divisione di Cardiologia (Dr Vignali), Ospedale Maggiore, Parma; the Unità Operativa di Cardiologia (Dr Sangiorgio), Ospedale Maggiore, Bologna; the Unità Operativa di Cardiologia (Dr Tondi), Ospedale di Baggiovara, Modena; and the Dipartimento Cure Primarie (Dr Serenelli), Azienda Sanitaria Locale di Ferrara, Ferrara, Italy.

Correspondence to: Gianluca Campo, MD, Cardiovascular Institute, Azienda Ospedaliera Universitaria S.Anna, via Aldo Moro 8, Cona (FE), 44124, Italy; e-mail: cmpglc@unife.it


For editorial comment see page 723

Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(3):750-757. doi:10.1378/chest.12-2313
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Background:  There are limited data describing the long-term outcome of patients with concomitant COPD who develop ST-segment elevation myocardial infarction (STEMI).

Methods:  A total of 11,118 consecutive patients with STEMI enrolled in the web-based Registro Regionale Angioplastiche Emilia-Romagna (REAL) registry were followed-up and stratified according to COPD presence or not. At 3-year follow-up, mortality and hospital readmissions due to myocardial infarction (MI), heart failure (HF), coronary revascularization (CR), serious bleeding, and COPD were assessed.

Results:  According to our criteria, 2,032 patients (18.2%) had a diagnosis of COPD. Overall, 1,829 patients (16.5%) died. COPD was an independent predictor of mortality (hazard ratio [HR], 1.4; 95% CI, 1.2-1.6). Hospital readmissions for recurrent MI (10% vs 6.9%, P < .01), CR (22% vs 19%, P < .01), HF (10% vs 6.9%, P < .01), and SB (10% vs 6%, P < .01) were significantly more frequent in patients with COPD as compared with those without. Also, hospital readmissions for COPD were more frequent in patients with a previous history of COPD as compared with those without (19% vs 3%; P < .01, respectively). Patients with a hospital readmission for COPD showed a fourfold increased risk of death (HR, 4.2; 95% CI, 3.4-5.2). Finally, hospital readmissions for COPD emerged as a strong independent risk factor for recurrence of MI (HR, 2.1; 95% CI, 1.4-3.3), HF (HR, 5.8; 95% CI, 4.6-7.5), and SB (HR, 3; 95% CI, 2.1-4.4).

Conclusions:  Patients with STEMI and concomitant COPD are at greater risk for death and hospital readmissions due to cardiovascular causes (eg, recurrent MI, HF, bleedings) than patients without COPD.

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