Prevalence and prognosis of chronic obstructive pulmonary disease among 5,839 consecutive patients with acute myocardial infarction

https://doi.org/10.1016/0002-9343(92)90196-IGet rights and content

Abstract

purpose: The purpose of this study was to report the prevalence and the clinical significance of clinically recognized chronic obstructive pulmonary disease (COPD) during acute myocardial infarction.

patients and methods: During 1981 to 1983, a secondary prevention study with nifedipine (SPRINT) was conducted in Israel among 2,276 survivors of acute myocardial infarction. During the study, demographic, historical, and medical data were collected on special forms for all patients with diagnosed acute myocardial infarction in 13 hospitals (the SPRINT Registry, n = 5,839). Mortality follow-up was completed for 99% of hospital survivors for a mean follow-up of 5.5 years (range: 4.5 to 7 years).

results: The prevalence of COPD was 7% (406 of 5,839). The latter rate increased significantly in men (7.6%), smokers (9.7%), and older patients (70 years or older, 10.0%). Patients with COPD exhibited a complicated hospital course with an in-hospital mortality rate of 23.9%. Subsequent mortality rates in survivors at 1 and 5 years were 12.3% and 35.9%, respectively. Rates at the same time periods in patients without COPD were 17.2%, 9.2%, and 26.9% (p <0.005 for in-hospital and 5 years).

In a multivariate analysis that included age, gender, and history of myocardial infarction and congestive heart failure, COPD was not independently associated with either in-hospital or postdischarge excess fatality rates.

conclusion: In this large cohort of consecutive patients with myocardial infarction, the prevalence of COPD was 7% and higher among smokers, men, and elderly patients. Although in-hospital and postdischarge mortality rates were higher among patients with COPD, this condition did not independently increase either the risk of early death or the risk of long-term mortality among survivors of acute myocardial infarction.

References (8)

There are more references available in the full text version of this article.

Cited by (54)

  • Chronic obstructive pulmonary disease and cardiovascular disease

    2013, Translational Research
    Citation Excerpt :

    Not surprisingly, COPD is also common in patients with CAD, although it is often undiagnosed.15 There are no population-based studies that examine this issue, but the prevalence of COPD in CAD in clinical studies has ranged from 7% to 34%,15,16 and the coexistence of the diseases appears to have important consequences, as shown by Zhang et al,17 who demonstrated that after percutaneous cardiac interventions, those with COPD had more adverse cardiac events and a longer hospital stay. There is sparse literature examining the frequency of CHF in patients with COPD, particularly studies that have adjusted for confounding risk factors such as age and smoking.

  • The impact of COPD on management and outcomes of patients hospitalized with acute myocardial infarction: A 10-year retrospective observational study

    2012, Chest
    Citation Excerpt :

    These wide variations in COPD prevalence likely reflect differences in the characteristics of patients studied and working definitions of COPD. Our observation that patients with COPD were older and had a worse cardiovascular profile than patients without COPD is consistent with the results of other investigations.8,14–16 Patients with COPD were more likely to have presented with dyspnea than with chest pain (62% vs 47%).

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

    2010, International Journal of Cardiology
    Citation Excerpt :

    Multivariate analyses (considering the baseline characteristics and the results of univariate analyses) indicated that COPD was an independent predictor of all-cause mortality, cardiovascular death, and cardiac death after PCI and CABG (Table 4). Smoking as a risk factor is common to both COPD and ischemic heart disease; hence, these 2 diseases often coexist [18,19]. Previous studies have shown that patients with COPD have a significantly higher risk of long-term all-cause mortality after PCI and CABG [5–14].

View all citing articles on Scopus

The collection of the SPRINT Registry data was supported by a research grant from Bayer AG (Wuppertal, Germany) within the framework of the SPRINT Study.

See Appendix.

View full text