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

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Andell, PontusLund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital (författare)

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

Artikel/kapitelEngelska2017

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2017-06-30
Oxford University Press (OUP),2017
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LIBRIS-ID:oai:DiVA.org:uu-341659
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-341659URI
https://doi.org/10.1093/ejcts/ezx219DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:136971833URI
https://lup.lub.lu.se/record/fa829104-e705-4834-84ef-ad7bdd31e582URI

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Språk:engelska
Sammanfattning på:engelska

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OBJECTIVES: Patients with chronic obstructive pulmonary disease (COPD) who also have acute coronary syndromes are a high-risk population with a high mortality rate. Little is known about these patients following coronary artery bypass grafting (CABG). METHODS: Patients presenting with acute coronary syndromes between 2006 and 2014 with an angiogram showing 3-vessel disease or left main coronary artery involvement who were treated with CABG or percutaneous coronary intervention (PCI) only were included from the nationwide SWEDEHEART registry. Patients were stratified according to COPD status and compared with regard to outcome. 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: We identified 6985 patients in the population who had CABG (COPD prevalence = 8.0%) and 14 209 who had PCI only (COPD = 8.2%). Patients with COPD were older and had more comorbidities than patients without COPD. The 5-year mortality rate was nearly doubled in patients with COPD versus patients without COPD (CABG: 27.2% vs 14.5%, P < 0.001; PCI only: 50.1% vs 29.1%, P < 0.001). After adjusting for age, sex and comorbidities, patients with COPD in both CABG-treated [hazard ratio = 1.52 (1.25-1.86), P < 0.001] and PCI-treated populations still had a significantly higher 5-year mortality rate. COPD was also independently associated with significantly 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]. CONCLUSIONS: Patients with COPD presenting with acute coronary syndromes and severe coronary artery disease are a high-risk population following CABG or PCI only, with higher risk of long-term and short-term death and postoperative infections. Preventive measures, including careful monitoring for signs of infection and prompt antibiotic treatment when indicated, should be considered.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Chronic obstructive pulmonary disease
Coronary artery bypass grafting
Percutaneous coronary intervention
Mortality
Infections
Chronic obstructive pulmonary disease
Coronary artery bypass grafting
Infections
Mortality
Percutaneous coronary intervention

Biuppslag (personer, institutioner, konferenser, titlar ...)

Sjögren, JohanLund University,Lunds universitet,Minimalinvasiv hjärtkirurgi vid hjärtklaffsjukdom,Forskargrupper vid Lunds universitet,Minimal invasive cardiac surgery in valvular heart disease,Lund University Research Groups,Skåne University Hospital(Swepub:lu)thor-js8 (författare)
Batra, GoravUppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi,Uppsala University Hospital(Swepub:uu)gorba357 (författare)
Szummer, KarolinaKarolinska Institutet,Karolinska University Hospital (författare)
Koul, SashaLund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-sku (författare)
Molekylär kardiologiForskargrupper vid Lunds universitet (creator_code:org_t)

Sammanhörande titlar

Ingår i:European Journal of Cardio-Thoracic Surgery: Oxford University Press (OUP)52:5, s. 930-9361010-79401873-734X

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Av författaren/redakt...: Andell, Pontus; Sjögren, Johan; Batra, Gorav; Szummer, Karolin ...; Koul, Sasha

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

Artiklar i publikationen: European Journal ...

Av lärosätet: Uppsala universitet; Karolinska Institutet; Lunds universitet

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