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Published on: August 24, 2019
Chronic obstructive pulmonary disease and periprocedural complications in patients undergoing percutaneous coronary
Rafał Januszek1, Artur Dziewierz1,2, Zbigniew Siudak3
12nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.
Insights
Patients with chronic obstructive pulmonary disease (COPD) undergoing percutaneous coronary interventions (PCI) experience more complications. COPD independently predicts increased no-reflow risk but decreased allergic reaction risk during PCI.
Area of Science:
- Cardiology
- Pulmonology
- Interventional Cardiology
Background:
- Chronic obstructive pulmonary disease (COPD) is a significant comorbidity affecting cardiovascular health.
- The impact of COPD on periprocedural complications following percutaneous coronary interventions (PCI) requires detailed investigation.
Purpose of the Study:
- To investigate the association between COPD and the rate and type of periprocedural complications in patients undergoing PCI.
- To identify predictors of these complications in the context of COPD.
Main Methods:
- Prospective data collection from the Polish Cardiovascular Intervention Society national registry (ORPKI) between January 2015 and December 2016.
- Analysis of 221,187 PCI procedures, comparing outcomes in 5,594 patients with COPD versus those without.
- Assessment of periprocedural complication frequency and predictors, including cardiac arrest, myocardial infarction, no-reflow, and allergic reactions.
Main Results:
- Patients with COPD were older (70.3 ± 9.9 vs. 67 ± 10.8 years).
- A higher incidence of periprocedural complications was observed in the COPD group (2.6% vs. 1.9%, p < 0.001), primarily driven by cardiac arrest, myocardial infarction, and no-reflow.
- COPD was not an independent predictor of overall complications but significantly predicted increased no-reflow risk (OR 1.447) and decreased allergic reaction risk (OR 0.117).
Conclusions:
- Periprocedural complications are more frequent in patients with COPD undergoing PCI.
- COPD is an independent predictor of increased no-reflow risk post-PCI.
- COPD is associated with a reduced risk of periprocedural allergic reactions during PCI.
Background:
The relationship between chronic obstructive pulmonary disease (COPD) and periprocedural complications of percutaneous coronary interventions (PCIs) is influenced by several factors. We aimed to investigate the association between COPD, its complication type and rate in patients undergoing PCI.
Methods:
Data were prospectively collected using the Polish Cardiovascular Intervention Society national registry (ORPKI) on all PCIs performed in Poland between January 2015 and December 2016. COPD was present in 5,594 of the 221,187 patients undergoing PCI. We assessed the frequency and predictors of periprocedural complications in PCI.
Results:
Patients with COPD were elder individuals (70.3 ± 9.9 vs. 67 ± 10.8 years; p < 0.05). We noted 145 (2.6%) periprocedural complications in the COPD group and 4,121 (1.9%) in the non-COPD group (p < 0.001). The higher incidence of periprocedural complications in the COPD patients was mainly attributed to cardiac arrest (p = 0.001), myocardial infarctions (p = 0.002) and no-reflows (p < 0.001). COPD was not an independent predictor of all periprocedural complications. On the other hand, COPD was found to be an independent predictor of increased no-reflow risk (odds ratio [OR] 1.447, 95% CI 1.085-1.929; p = 0.01), and at the same time, of decreased risk of periprocedural allergic reactions (OR 0.117, 95% CI 0.016-0.837; p = 0.03).
Conclusions:
In conclusion, periprocedural complications of PCIs are more frequent in patients with COPD. COPD is an independent positive predictor of no-reflow and a negative predictor of periprocedural allergic reactions.
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