Chronic obstructive pulmonary disease--an independent risk factor for long-term cardiac and cardiovascular mortality in patients with ischemic heart disease

Int J Cardiol. 2010 Aug 20;143(2):178-83. doi: 10.1016/j.ijcard.2009.02.010. Epub 2009 Apr 14.

Abstract

Background: Limited data are available on long-term mortality and morbidity of patients with chronic obstructive pulmonary disease (COPD) and ischemic heart disease. We examined how COPD affects long-term mortality and morbidity after undergoing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).

Methods: We analyzed 9877 consecutive patients who underwent their first elective PCI (n=6878) and CABG (n=2999) in 2000-2002 at 30 institutions listed in the CREDO-Kyoto registry.

Results: COPD was diagnosed in 240 patients (2.4%). In-hospital mortality (1.3% vs. 1.2%, p=0.972) did not differ between patients with and without COPD. During long-term follow-up (42. 8 month s), 906 patients (9.4%) died, 517 (5.3%) of whom died of cardiovascular death and 376 (3.9%), of cardiac death. At 3 years, the unadjusted survival rate and the rates of freedom from cardiovascular death and cardiac death were 92.1%, 95.3%, and 96.5% in the total population and 82.8%, 91.7%, and 92.1% in patients with COPD respectively. Log-rank test indicated that COPD was associated with higher incidence of all-cause mortality (p<0.0001), cardiovascular death (p=0.0002), and cardiac death (p<0.0001). Multivariate analyses indicated that COPD was an independent predictor of all-cause mortality (hazard ratio 1.36, p=0.0003), cardiovascular death (hazard ratio 1.28, p=0.0407), and cardiac death (hazard ratio 1.48, p=0.003).

Conclusions: COPD is an independent risk factor for long-term cardiac and cardiovascular mortality in patients with ischemic heart disease.

MeSH terms

  • Angioplasty, Balloon, Coronary / mortality*
  • Comorbidity
  • Coronary Artery Bypass / mortality*
  • Female
  • Follow-Up Studies
  • Hospital Mortality
  • Humans
  • Japan / epidemiology
  • Male
  • Morbidity
  • Myocardial Ischemia / mortality*
  • Myocardial Ischemia / surgery
  • Myocardial Ischemia / therapy
  • Pulmonary Disease, Chronic Obstructive / mortality*
  • Registries
  • Risk Factors