Closing the mortality gap after a myocardial infarction in people with and without chronic obstructive pulmonary disease

Heart
Kieran J RothnieJennifer K Quint

Abstract

Patients with chronic obstructive pulmonary disease (COPD) have increased mortality following myocardial infarction (MI) compared with patients without COPD. We investigated the extent to which differences in recognition and management after MI could explain the mortality difference. 300 161 patients with a first MI between 2003 and 2013 were identified in the UK Myocardial Ischaemia National Audit Project database. Logistic regression was used to compare mortality in hospital and at 180 days postdischarge between patients with and without COPD. Variables relating to inhospital factors (delay in diagnosis, use of reperfusion and time to reperfusion/use of angiography) and use of secondary prevention were sequentially added to models. Mortality was higher for patients with COPD both inhospital (4.6% vs 3.2%) and at 180 days (12.8% vs 7.7%). After adjusting for inhospital factors, the effect of COPD on inhospital mortality after MI was reduced for both ST-elevation myocardial infarctions (STEMIs) and non-STEMIs (STEMIs OR 1.24 (95% CI 1.10 to 1.41) to 1.13 (95% CI 0.99 to 1.29); non-STEMIs OR 1.34 (95% CI 1.24 to 1.45) to 1.16 (95% CI 1.07 to 1.26)). Adjusting for inhospital factors reduced the effect of COPD on mortality after n...Continue Reading

References

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Citations

Sep 7, 2016·The Lancet. Respiratory Medicine·Charlotte E BoltonMark T Dransfield
Jun 11, 2016·Chronic Respiratory Disease·K J Rothnie, J K Quint
Oct 13, 2016·ERJ Open Research·William D-C ManSally J Singh
Feb 15, 2020·British Journal of Clinical Pharmacology·Christopher J D ThreapletonEmma H Baker
Apr 1, 2016·European Heart Journal. Quality of Care & Clinical Outcomes·Kieran J Rothnie, Jennifer K Quint
Jan 23, 2018·Therapeutic Advances in Respiratory Disease·Ann D MorganJennifer K Quint
Sep 19, 2019·Kardiologiia·Z R AisanovE N Kalmanova
Sep 30, 2020·Journal of Clinical Medicine·Kazuto MatsunagaTsunahiko Hirano
Sep 3, 2016·American Journal of Respiratory and Critical Care Medicine·Sara RoversiAlvar Agustí
May 4, 2018·Annals of the American Thoracic Society·Kieran J RothnieJennifer K Quint
Aug 14, 2018·European Heart Journal·James Brian ByrdUNKNOWN SUMMIT Investigators
Jun 26, 2020·European Respiratory Review : an Official Journal of the European Respiratory Society·Laurien GoedemansVictoria Delgado
Sep 28, 2018·Medical Sciences : Open Access Journal·Rosa Malo de MolinaPiedad Ussetti
Oct 22, 2020·Expert Review of Respiratory Medicine·Paola RoglianiLuigino Calzetta
Aug 21, 2021·International Journal of Chronic Obstructive Pulmonary Disease·Rachel PullenDavid B Price

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

CALIBER
MINAP

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