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Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions.

Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions.
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Januszek R, Siudak Z, Dziewierz A, Rakowski T, Dudek D, Bartuś S,


Januszek R, Siudak Z, Dziewierz A, Rakowski T, Dudek D, Bartuś S, (click to view)

Januszek R, Siudak Z, Dziewierz A, Rakowski T, Dudek D, Bartuś S,

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Polish archives of internal medicine 2017 11 07() doi 10.20452/pamw.4145
Abstract

INTRODUCTION    The incidence of chronic obstructive pulmonary disease (COPD) in patients treated with percutaneous coronary interventions (PCIs) is underestimated, and the effect of COPD on PCI and atherosclerosis is not fully understood.  OBJECTIVES    The aim of this study was to assess the impact of COPD on periprocedural outcomes of PCIs and its relationship with clinical presentation and type of coronary artery lesions.  PATIENTS AND METHODS    Data were prospectively collected using the National PCI Registry (ORPKI) electronic database of all PCI procedures performed in Poland. In total, 5594 patients had diagnosed COPD before PCI from 221187 PCI procedures. RESULTS    Patients with COPD were older (70.3 [9.9] vs 67 [10.8]; P<0.001) and more often males (72.3% vs 67.8%; P<0.001). Non-ST-segment elevation myocardial infarction (NSTEMI) was a more common clinical presentation of coronary artery disease (CAD) in the COPD group, while ST-segment elevation myocardial infarction (STEMI) occurred more frequently in the non-COPD group. The multi-vessel disease +/- left main coronary artery involvement and separate LMCA was diagnosed more often in the COPD group. At baseline, the culprit lesion was more often restenosis and in-stent thrombosis in patients from the COPD group, whereas de-novo lesion in the non-COPD group. The periprocedural mortality (0.53% vs  0.45%; P=0.39) and MI (0.13% vs. 0.12%; P=0.88) rate did not differ significantly between both groups. COPD was found to be an independent predictor of restenosis assessed before PCI in patients with peracted PCI procedure in the past (P=0.006). CONCLUSIONS    Patients with COPD are at increased risk of MVD +/- LMCA involvement and NSTEMI before PCI. Restenosis and in-stent thrombosis occurred more often in patients with COPD before PCI.

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