REPEAT MYOCARDIAL REVASCULARIZATION IN LONG-TERM PERIOD AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND STABLE ANGINA PECTORIS

Abstract

Objective. To assess the effect of some characteristics of chronic obstructive pulmonary disease (COPD) in patients after elective percutaneous coronary intervention (PCI) on repeat myocardial revascularization frequency in long-term period (up to 3 year).Materials and methods. 135 patients with COPD, who suffered stable ischemic heart disease and were underwent PCI, were included in prospective observational study. Follow-up duration was up to3 year. Evaluation included comparing the frequency of elective repeat revascularization in regards to frequent COPD exacerbations, COPD severity, lung function and C-reactive protein (CRP) plasm level. Comparing Kaplan-Mayer curves and Cox regression analysis were also applied.Results. Elective repeat myocardial revascularization frequency was 23% and 2,1 times higher among the patients who had frequent COPD exacerbations history (95% CI 1,1-3,9). The difference between Kaplan-Mayers curves was also detected as statistically significant (p=0,016). None of the pulmonary function characteristics had relations with elective repeat revascularization frequency increase. Frequent COPD exacerbations history and CRP plasma level were included in Cox regression model as non-cardiovascular variables (p=0,05 and 0,08 respectively).Conclusions. Frequent COPD exacerbations history and increased CRP plasma level are indepen- dent non-cardiovascular variables related to increased risk of elective repeat myocardial revasculariza- tion. None of the pulmonary function characteristics had relations with elective repeat revasculariza- tion frequency increase.

Keywords

chronic obstructive pulmonary disease / elective percutaneous coronary intervention / repeat myocardial revascularization

References

[1] Enriquez J.R., Parikh S.V., Selzer F. et al. Increased adverse events after percutaneous coronary intervention in patients with COPD: insights from the National Heart, Lung, and Blood Institute dynamic registry. Chest. 2011. Vol. 140, N 3. P. 604-610. doi: 10.1378/chest.10-2644

[2] Konecny T., Somers K., Orban M. et al. Interactions between COPD and outcomes after percutaneous coronary intervention. Chest. 2010. Vol. 138, N 3.P. 621-627. doi: 10.1378/chest.10-0300.

[3] Pant S., Deshmukh A., Gurumurthy G.S. et al. Inflammation and atherosclerosis - revisited. J Cardiovasc Pharmacol Ther. 2014. Vol. 19, N 2. P. 170-178. doi: 10.1177/1074248413504994.

[4] van Diepen J.A., Berbée J.F., Havekes L.M. et al. Interactions between inflammation and lipid metabolism: relevance for efficacy of anti-inflammatory drugs in the treatment of atherosclerosis.Atherosclerosis.2013.Vol.228, N 2. P. 306-315. doi: 10.1016/j.atherosclerosis.2013.02.028.

[5] Donaldson G.C., Hurst J.R., Smith C.J. et al. Increased risk of myocardial infarction and stroke following exacerbation of COPD. Chest. 2010. Vol. 137, N 5. P. 1091-1097. doi: 10.1378/chest.09-2029.

[6] Marsch E., Sluimer J.C., Daemen M.J. Hypoxia in atherosclerosis and inflammation. Curr Opin Lipidol. 2013. Vol. 24, N 5. P. 393-400. doi: 10.1097/ MOL.0b013e32836484a4.

RIGHTS & PERMISSIONS

Zafiraki V.K., Kosmacheva E.D.