TCT-312 Increased Cardiac Death and Stent Thrombosis in Chronic Obstructive Pulmonary Disease Patients Undergoing Percutaneous Coronary Intervention. An analysis of the BASKET-PROVE I and II trials

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  • Tannas Jatene
  • Biering-Sørensen, Tor
  • Kotaro Nochioka
  • Fernanda Mangione
  • Kim Hansen
  • Rikke Sørensen
  • Jan Skov Jensen
  • Peter Jørgensen
  • Raban Jeger
  • Christoph Kaiser
  • Matthias Pfisterer
  • Soeren Galatius
Background COPD is associated with long-term all-cause death following PCI with bare-metal stents (BMS). 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 sought to evaluate the impact of chronic obstructive pulmonary disease (COPD) on percutaneous coronary intervention (PCI) outcomes, and the interaction with stent type. Methods We analyzed 4605 patients that underwent PCI with BMS (33.1%) or DES (66.9%) from the BASKET-PROVE trials I and II. Results 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, non-fatal myocardial infarction (MI) and target vessel revascularization]: 15.2 vs. 8.1% (p<0.001); all-cause death: 11.7 vs. 2.4%, (p<0.001); cardiac death: 5.7 vs. 1.2%, (p<0.001); MI: 3.5 vs. 1.9% (p=0.045); definite/probable/possible stent thrombosis: 2.5 vs. 0.9% (p=0.01); and major bleeding: 4.2 vs. 2.1% (p=0.014). After adjusting for confounders including smoking status, COPD remained an independent predictor for MACE (HR 1.80, 95%CI 1.31-2.49), all-cause death (HR 3.62, 95%CI 2.41-5.45), cardiac death (HR 3.12, 95%CI 1.74-5.60) and stent thrombosis (HR 2.39, 95% CI 1.03-5.54). We did not find evidence of an interaction between COPD and DES implantation (P for interaction = 0.29).
Original languageEnglish
JournalJournal of the American College of Cardiology
Volume68
Issue number18 S1
Pages (from-to)B129
Number of pages1
ISSN0735-1097
DOIs
Publication statusPublished - Nov 2016

ID: 180818252