Long-Term Outcomes for Chinese COPD Patients After PCI: A Propensity Score Matched, Double-Cohort Study

Frontiers in Cardiovascular Medicine

article

Yitian Zheng¹  Yu Qi³  Samuel Seery⁴  Wenyao Wang³  Wei Zhao³  Tao Shen³  Lequn Zhou³  Jie Yang¹  Chen Li¹  Xuliang Wang¹  Jun Gao³  Xiangbin Meng³  Erdan Dong³  Yi-Da Tang³ 

[1] Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College;Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College;Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research;School of Humanities and Social Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College;Faculty of Health and Medicine, Division of Health Research, Lancaster University;The Institute of Cardiovascular Sciences, Peking University

关键词: chronic obstructive pulmonary disease;    coronary artery disease;    percutaneous coronary intervention;    outcomes;    aging;   

DOI  :  10.3389/fcvm.2022.827635

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Objectives The aim of this study was to analyze long-term outcomes of Chinese coronary artery disease (CAD) patients with (and without) chronic obstructive pulmonary disease (COPD) after percutaneous coronary intervention (PCI). Background Chronic obstructive pulmonary disease is a chronic condition which often develops in conjunction with CAD. PCI is a core therapy for CAD, although we still need to understand CAD-COPD outcomes and to identify factors that influence prognoses, across ethnicities. Methods This double-cohort study involved 12,343 Chinese CAD patients who received PCI. Baseline characteristics were collected in two independent, specialty centers. Propensity-score matching was performed to control confounding factors, using a nearest neighbor matching method within a 0.02 caliper and on a propensity score scale of 0.1 for each center. Comorbid CAD-COPD cases were compared to non-COPD patients in terms of major adverse cardiac events (MACEs). Results Patients with COPD were generally older than those without COPD (65.4 ± 9.2 vs. 58.2 ± 10.3, p 0.05); however, the incidence of MACEs increased after 450 days. Further subgroup analysis suggests that COPD is approximately four times more prevalent among those aged over 75 years (HR, 3.818; 95%CI, 1.10–13.29; p = 0.027) and those aged below 55 years (HR = 4.254; 95% CI, 1.55–11.72; p = 0.003). Conclusion Having COPD does not appear to have a significant impact on CAD outcomes 2 years after PCI, and beyond. However, an increasing number of MACEs was observed after 450 days, which suggests that there may be a double-stage effect of COPD on PCI prognosis. There is a need for focused comorbidity management, specifically for those aged below 55 years and above 75 years.

【 授权许可】

CC BY