Long-term survival of patients with chronic obstructive pulmonary disease undergoing coronary artery bypass surgery

Circulation. 2006 Jul 4;114(1 Suppl):I430-4. doi: 10.1161/CIRCULATIONAHA.105.000943.


Background: Chronic obstructive pulmonary disease (COPD) is associated with increased in-hospital mortality in patients undergoing coronary artery bypass surgery (CABG). Long-term survival is less well understood. The present study examined the effect of COPD on survival after CABG.

Methods and results: We conducted a prospective study of 33,137 consecutive isolated CABG patients between 1992 and 2001 in northern New England. Records were linked to the National Death Index for long-term mortality data. Cox proportional hazards regression was used to calculate hazard ratios (HRs). Patients were stratified by: no comorbidities (none), COPD, COPD plus comorbidities, and other comorbidities with no COPD. There were 131,434 person years of follow-up and 5344 deaths. The overall incidence rate (deaths per 100 person years) was 4.1. By group, rates were: 2.1 (none), 4.0 (COPD alone), 5.5 (other), and 9.4 (COPD plus; log rank P<0.001). After adjustment, survival with COPD alone was worse compared with none (HR, 1.8; 95% CI, 1.6 to 2.1; P<0.001). Patients with other comorbidities compared with none had even worse survival (HR, 2.2; 95% CI, 2.1 to 2.4; P<0.001). Patients with COPD plus other comorbidities compared with none had the worst long-term survival (HR, 3.6; 95% CI, 3.3 to 3.9; P<0.001).

Conclusions: Patients with only COPD had significantly reduced long-term survival compared with patient with no comorbidities. Patients with COPD and > or = 1 other comorbidity had the worst survival rate when compared with all of the other groups.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Coronary Artery Bypass* / statistics & numerical data
  • Coronary Disease / complications
  • Coronary Disease / epidemiology
  • Coronary Disease / surgery*
  • Databases, Factual
  • Diabetes Complications / surgery
  • Female
  • Follow-Up Studies
  • Heart Failure / epidemiology
  • Humans
  • Kidney Diseases / epidemiology
  • Life Tables
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Peptic Ulcer / epidemiology
  • Peripheral Vascular Diseases / epidemiology
  • Prevalence
  • Proportional Hazards Models
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Registries
  • Survival Analysis
  • Treatment Outcome