Preview

Rational Pharmacotherapy in Cardiology

Advanced search

RESULTS OF TREATMENT OF ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: DATA OF A RETROSPECTIVE, SINGLE-CENTER STUDY (IN-HOSPITAL PERIOD)

https://doi.org/10.20996/1819-6446-2015-11-6-561-570

Full Text:

Abstract

Myocardial infarction significantly contributes to mortality rates in patients with chronic obstructive pulmonary disease (COPD). The influence of COPD on the course of acute ST-segment elevation myocardial infarction (STEMI) is controversial.

Aim. To evaluate characteristics of coronary artery lesions and cardiovascular complications in STEMI patients with and without COPD depending on a reperfusion treatment method during in-hospital stay.

Material and methods. A total of 1112 cases of STEMI treatment within the first 6 hours of the symptoms onset were analyzed. All of these patients have undergone reperfusion treatment: primary percutaneous coronary intervention (PPCI) or pharmacoinvasive strategy (PIS) methods. All the patients were divided into two groups: patients without COPD (952 persons; 83.2%) and those with COPD (160 patients; 16.8%). COPD impact on in-hospital course of STEMI was assessed.

Results. The presence of COPD had no influence on STEMI in-hospital mortality. Mortality rates in patients with COPD (12 subjects; 7.5%) and without COPD (83 subjects; 8.7%) did not differ significantly (p=0.2). The study has demonstrated the significant influence of COPD on the patients’ baseline characteristics and treatment results, which can have an impact on long-term prognosis. According to our data COPD presence was associated with more severe coronary artery lesions in both PPCI and PIS subgroups (p<0.001). This has determined more frequent transmural myocardial damage in STEMI patients with COPD regardless of reperfusion strategy and time factor (79% in patients with COPD and 50% in those without one, p<0.001). The incidence of hemorrhagic complications also didn’t depend on COPD presence and remained low in all groups.

Conclusion. At COPD presence STEMI was associated with more severe coronary artery lesions and increased frequency of transmural myocardial damage and residual stenosis after thrombolytic therapy. COPD did not lead to the increase in in-hospital mortality rates in STEMI patients undergoing reperfusion treatment.

About the Authors

D. B. Nemick
Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky Partizana Zhelezniaka ul. 1, Krasnoyarsk, 660022 Russia Regional Clinical Hospital. Partizana. Zhelezniaka ul. 3a, Krasnoyarsk, 660022 Russia
Russian Federation

MD, assistant of the Department of Cardiology and Functional Diagnostics, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky



G. V. Matyushin
Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky Partizana Zhelezniaka ul. 1, Krasnoyarsk, 660022 Russia
Russian Federation

MD, PhD, Professor, Head of the same Department



A. V. Protopopov
Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky Partizana Zhelezniaka ul. 1, Krasnoyarsk, 660022 Russia Regional Clinical Hospital. Partizana. Zhelezniaka ul. 3a, Krasnoyarsk, 660022 Russia
Russian Federation

MD, PhD, Professor of the Department of Radiology, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky



S. A. Ustyugov
Regional Clinical Hospital. Partizana. Zhelezniaka ul. 3a, Krasnoyarsk, 660022 Russia
Russian Federation

MD, PhD, Head of the Cardiology Unit №3, Regional Clinical Hospital



A. V. Shulmin
Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky Partizana Zhelezniaka ul. 1, Krasnoyarsk, 660022 Russia
Russian Federation

MD, PhD, Head of the Department of Public Health and Healthcare with Social Work Course, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky



References

1. Armstrong PW, Gershlick AH, Goldstein P, et al; STREAM Investigative Team. Fibrinolysis or Primary PCI in ST-Segment Elevation Myocardial Infarction. N Engl J Med. 2013; 368 (15): 87-1379.

2. Bhatt NS, Solhpour A, Balan P, et al. Comparison of in-hospital outcomes with low-dose fibrinolytic therapy followed by urgent percutaneous coronary intervention versus percutaneous coronary intervention alone for treatment of ST-elevation myocardial infarction. Am J Cardiol 2013; 111: 1576-9.

3. Zhang J, Rutten FH, Cramer MJ, et al. The importance of cardiovascular disease for mortality in patients with COPD: a prognostic cohort study. Fam Pract 2011; 28 (5): 474-81.

4. Man SF, Leipsic JA, Man JP, Sin DD. Is atherosclerotic heart disease in COPD a distinct phenotype? Chest 2011; 140 (3): 569-71.

5. Rothnie KJ, Yan R, Smeeth L, Quint JK. Risk of myocardial infarction (MI) and death following MI in people with chronic obstructive pulmonary disease(COPD): a systematic review and meta-analysis. BMJ Open 2015; 5 (9): e007824.

6. Almagro P, Lapuente A, Pareja J, et al. Underdiagnosis and prognosis of chronic obstructive pulmonary disease after percutaneous coronary intervention: a prospective study. Int J Chron Obstruct Pulmon Dis 2015; 10: 1353-61.

7. Zhang JW, Zhou YJ, Yang Q, et al. Impact of chronic obstructive pulmonary diseases on outcomes and hospital days after percutaneous coronary intervention. Angiology 2013; 64 (6): 430-4.

8. Rynkowska-Kidawa M, Zielinska M, Chizynski K, Kidawa M. In-hospital outcomes and mortality in octogenarians after percutaneous coronary intervention. Kardiol Pol 2015; 73 (6): 396-403.

9. Campo G, Guastaroba P, Marzocchi A, et al. Impact of COPD on long-term outcome after ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention. Chest 2013; 144 (3): 750-7.

10. Yin L, Lensmar C, Ingelsson E, Bäck M. Differential association of chronic obstructive pulmonary disease with myocardial infarction and ischemic stroke in a nation-wide cohort. Int J Cardiol. 2014; 173 (3): 601-3.

11. Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006; 27 (2): 397-412.

12. Polikutina OM, Slepynina IuS, Bazdyrev ED, et al. New-onset chronic obstructive pulmonary disease and its clinical significance in patients with ST-segment elevation myocardial infarction. Ter Arkh 2014; 86 (3): 14-9. In Russian (Поликутина О.М., Слепынина Ю.С., Баздырев Е.Д., и др. Впервые выявленная хроническая обструктнвная болезнь легких и ее клиническая значимость у больных с инфарктом миокарда с подъемом сегмента ST. Терапевтический архив 2014: 86(3);14-9).

13. Sung PH, Chung SY, Sun CK, et al. Impact of chronic obstructive pulmonary disease on patient with acute myocardial infarction undergoing primary percutaneous coronary intervention. Biomed J 2013; 36 (6): 274-81.

14. Rothnie KJ, Smeeth L, Herrett E, et al. Closing the mortality gap after a myocardial infarction in people with and without chronic obstructive pulmonary disease. Heart 2015; 101(14): 1103-10.

15. Soltani A, Reid D, Wills K, Walters EH. Prospective outcomes in patients with acute exacerbations of chronic obstructive pulmonary disea J 2015; 45 (9): 925-33.

16. Rajagopalan S, Brook RD. Mortality from myocardial infarction in chronic obstructive pulmonary disease: minding and mending the 'Gap'. Heart 2015; 101 (14):1085-6.

17. Schiele F, Puymirat E, Cattan S, et al. Impact of chronic obstructive pulmonary disease on early and late mortality in patients after an acute myocardial infarction. Insights from FAST-MI 2005 registry. Eur Heart J 2013; 34 (1): 567.

18. Lazzeri C1, Valente S, AttanàP, et al. The prognostic role of chronic obstructive pulmonary disease in ST-elevation myocardial infarction after primary angioplasty. Eur J Prev Cardiol 2013; 20 (3): 392-8.

19. Campo G, Guastaroba P, Marzocchi A, et al. Impact of COPD on long-term outcome after ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention. Chest 2013; 144 (3): 750-7.


For citation:


Nemick D.B., Matyushin G.V., Protopopov A.V., Ustyugov S.A., Shulmin A.V. RESULTS OF TREATMENT OF ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: DATA OF A RETROSPECTIVE, SINGLE-CENTER STUDY (IN-HOSPITAL PERIOD). Rational Pharmacotherapy in Cardiology. 2015;11(6):561-570. (In Russ.) https://doi.org/10.20996/1819-6446-2015-11-6-561-570

Views: 456


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)