Andell P, et al. - Researchers sought to assess outcome of patients with chronic obstructive pulmonary disease and severe coronary artery disease who had a coronary artery bypass graft or a percutaneous coronary intervention. Findings revealed that these patients were at higher risk of long-term and short-term death and postoperative infections. They recommended considering preventive measures, including careful monitoring for signs of infection and prompt antibiotic treatment when indicated.

Methods

• From 2006 to 2014, researchers identified patients presenting with acute coronary syndromes with an angiogram showing 3-vessel disease or left main coronary artery involvement who were treated with CABG or percutaneous coronary intervention (PCI) only from the nationwide SWEDEHEART registry.
• Patients were divided in accordance to COPD status and compared with regard to outcome.
• For this study, the primary end-point was the 5-year mortality rate; secondary outcomes were the 30-day mortality rate and in-hospital complications after CABG.

Results

• In the population, researchers identified 6985 patients who had CABG (COPD prevalence = 8.0%) and 14 209 who had PCI only (COPD = 8.2%).
• Compared to patients without COPD, patients with COPD were older and had more comorbidities.
• In patients with COPD, the 5-year mortality rate was nearly doubled when compared to patients without COPD (CABG: 27.2% vs 14.5%, P < 0.001; PCI only: 50.1% vs 29.1%, P < 0.001).
• Patients with COPD in both CABG-treated [hazard ratio = 1.52 (1.25–1.86), P < 0.001] and PCI-treated populations indicated significantly higher 5-year mortality rate even after adjusting for age, sex and comorbidities.
• In addition, COPD seemed independently associated with markedly more postoperative infections in need of antibiotics [odds ratio = 1.48 (1.07–2.04), P = 0.017] and pneumonia [odds ratio = 2.21 (1.39–3.52), P = 0.001].