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3-years outcome of follow-up of patients with chronic obstructive pulmonary disease successfully treated by percutaneous coronary intervention due to acute coronary syndrome

https://doi.org/10.18087/cardio.2020.9.n1263

Abstract

Aim To evaluate results of three-year follow-up in patients after acute coronary syndrome (ACS) associated with chronic obstructive pulmonary disease (COPD) and to identify predictors for delayed serious cardiovascular adverse (SCVAE) events.
Material and methods This prospective cohort study included 119 patients with verified COPD who had ACS after a successful urgent percutaneous coronary intervention and were discharged from the hospital without in-hospital complications. Incidence of and time to SCVAE (cardiovascular death, myocardial infarction, stroke, repeated unscheduled myocardial revascularization) were recorded. SCVAE predictors were identified with the Cox regression by stepwise inclusion of variables into the model.
Results SCVAE occurred in 33.6 % of ACS patients with COPD. The high rate of repeated myocardial revascularization mostly contributed to the development of delayed SCVAEs (19.3 % of patients). Independent predictors of SCVAE included the total number of stenoses in major coronary artery branches; ankle-brachial index; glomerular filtration rate calculated with the CKD-EPI equation; frequent COPD exacerbations; functional residual capacity of the lungs; and 6-min walk distance.
Conclusion New independent predictors of SCVAE were identified in COPD patients after ACS with percutaneous coronary intervention and stenting, including distance in the 6-min walk test, frequent COPD exacerbations, and functional residual volume of the lungs as an index of pulmonary hyperinflation.

About the Authors

V. K. Zafiraki
«Kuban State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnodar, Russia Regional Clinical Hospital #1, Krasnodar, Russia
Russian Federation
docent of thepapy chair


E. D. Kosmacheva
«Kuban State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnodar, Russia Scientific Research Institution – Ochapovsky S.V. Regional Clinical Hospital #1, Krasnodar, Russia
Russian Federation
Head of therapy chair, Deputy Chief Medical Officer


L. V. Shulzhenko
«Kuban State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnodar, Russia Scientific Research Institution – Ochapovsky S.V. Regional Clinical Hospital #1, Krasnodar, Russia
Russian Federation
Head of pulmunary chair, Head of pulmonary department


N. V. Kizhvatova
Scientific Research Institution – Ochapovsky S.V. Regional Clinical Hospital #1, Krasnodar, Russia
Russian Federation
Head of cardiology department No3


E. A. Nemtsova
Scientific Research Institution – Ochapovsky S.V. Regional Clinical Hospital #1, Krasnodar, Russia
Russian Federation
cardiologist of cardiology department No3


I. V. Pershukov
Osh State University, Osh, Kyrgyzstan Voronezh Regional Clinical Hospital #1, Voronezh, Russia
Russian Federation
Professor of therapy Chair, Cargiologist, FACC, FSCAI


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Review

For citations:


Zafiraki V.K., Kosmacheva E.D., Shulzhenko L.V., Kizhvatova N.V., Nemtsova E.A., Pershukov I.V. 3-years outcome of follow-up of patients with chronic obstructive pulmonary disease successfully treated by percutaneous coronary intervention due to acute coronary syndrome. Kardiologiia. 2020;60(9):84-91. https://doi.org/10.18087/cardio.2020.9.n1263

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