Frequency of Cardiac Death and Stent Thrombosis in Patients With Chronic Obstructive Pulmonary Disease Undergoing Percutaneous Coronary Intervention (from the BASKET-PROVE I and II Trials)

Research output: Contribution to journalJournal articleResearchpeer-review

  • Tannas Jatene
  • Biering-Sørensen, Tor
  • Kotaro Nochioka
  • Fernanda Marinho Mangione
  • Kim Wadt Hansen
  • Rikke Sørensen
  • Jan Skov Jensen
  • Peter Godsk Jørgensen
  • Raban Jeger
  • Christoph Kaiser
  • Matthias Pfisterer
  • Søren Galatius
  • BASKET-PROVE Investigators

Chronic obstructive pulmonary disease (COPD) is associated with long-term all-cause death after percutaneous coronary intervention with bare-metal stents. Regarding other outcomes, previous studies have shown conflicting results and the impact of drug-eluting stent (DES) in this population is not well known. We analyzed 4,605 patients who underwent percutaneous coronary intervention with bare-metal stents (33.1%) or DES (66.9%) from the Basel Stent Kosten-Effektivitats Trial-Prospective Validation Examination trials I and II. COPD patients (n = 283, 6.1%), were older and had more frequently a smoking or cardiovascular event history. At 2-year follow-up, cumulative event rates for patients with versus without COPD were the following: major adverse cardiac events (MACE: composite of cardiac death, nonfatal myocardial infarction, and target vessel revascularization): 15.2% versus 8.1% (p <0.001); all-cause death: 11.7% versus 2.4% (p <0.001); cardiac death: 5.7% versus 1.2% (p <0.001); myocardial infarction: 3.5% versus 1.9% (p = 0.045); definite/probable/possible stent thrombosis: 2.5% versus 0.9% (p = 0.01); and major bleeding: 4.2% versus 2.1% (p = 0.014). After adjusting for confounders including smoking status, COPD remained an independent predictor for MACE (hazard ratio [HR] 1.80, 95% confidence interval [CI] 1.31 to 2.49), all-cause death (HR 3.62, 95% CI 2.41 to 5.45), cardiac death (HR 3.12, 95% CI 1.74 to 5.60), and stent thrombosis (HR 2.39, 95% CI 1.03 to 5.54). We did not find evidence of an interaction between COPD and DES implantation (p for interaction = 0.29) for MACE. In conclusion, COPD is associated with increased 2-year rates of all-cause death, cardiac death, and stent thrombosis after stent implantation. DES use appears to be beneficial also in patients with COPD.

Original languageEnglish
JournalAmerican Journal of Cardiology
Volume119
Issue number1
Pages (from-to)14-19
Number of pages6
ISSN0002-9149
DOIs
Publication statusPublished - 1 Jan 2017

    Research areas

  • Aged, Cardiovascular Agents/administration & dosage, Coronary Disease/mortality, Coronary Thrombosis/etiology, Drug-Eluting Stents/adverse effects, Female, Graft Occlusion, Vascular/etiology, Humans, Male, Middle Aged, Percutaneous Coronary Intervention/adverse effects, Prospective Studies, Pulmonary Disease, Chronic Obstructive/complications, Risk Factors, Stents/adverse effects, Treatment Outcome

ID: 194776543