Interactions between COPD and outcomes after percutaneous coronary intervention.

Abstract

COPD is common in patients undergoing percutaneous coronary intervention (PCI), but its association with outcomes following PCI has received only limited study. The effects of COPD severity on outcomes after PCI are not known. We conducted a retrospective cross-sectional analysis of prospectively acquired data in 14,346 consecutive patients enrolled in the Mayo Clinic PCI registry. Patients with COPD were identified by International Classification of Diseases, 9th edition, coding and pulmonary function test (PFT) results. Outcomes of COPD vs non-COPD cohorts were compared. The COPD group included 2,001 patients (72% men) aged 70 +/- 10 years, and the non-COPD group included 12,345 patients (70% men) aged 66 +/- 12 years. In the follow-up period after PCI (median, 4.1 years; interquartile range, 1.9-7.0 years), the patients with COPD experienced a significantly higher incidence of all-cause mortality (P < .0001), cardiac mortality (P < .0001), and myocardial infarction (MI) (P < .0001) than the patients without COPD. Additionally, severity of COPD was associated with increased mortality after PCI (P < .0001). In a multivariate analysis, COPD presence and severity remained significant risk factors for mortality (P < .0001), cardiac mortality (P < .0001), and occurrence of MI after PCI (P < .0001). COPD is associated with significantly increased overall long-term mortality, cardiac mortality, and occurrence of MI in patients undergoing PCI. Increasing severity of COPD as measured by PFT is associated with decreased survival after PCI. Screening for COPD in patients undergoing PCI could contribute importantly to risk stratification, identifying patients needing closer follow-up and optimizing targeted therapeutic interventions.