Effect of Chronic Obstructive Pulmonary Disease on In-Hospital Mortality and Clinical Outcomes After ST-Segment Elevation Myocardial Infarction

Manyoo Agarwal, Sahil Agrawal, Lohit Garg, Aakash Garg, Nirmanmoh Bhatia, Dipen Kadaria, Guy Reed

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

There is controversy regarding in-hospital mortality, revascularization, and other adverse outcomes in patients with ST-segment elevation (STEMI) and chronic obstructive pulmonary disease (COPD). We queried the 2003 to 2011 Nationwide Inpatient Sample databases to identify patients aged ≥18 years with a primary diagnosis of STEMI. Univariate and multivariate analyses were performed to evaluate the association of COPD with in-hospital clinical outcomes. Patients with COPD comprised 13.2% of 2,120,005 patients with STEMI. COPD was associated with older age, Medicare insurance, greater co-morbidities, and lower socioeconomic status. Compared with non-COPD patients, patients with COPD had higher inpatient mortality even after adjustment for multiple potential other factors (12.5% vs 8.6%, adjusted odds ratio [AOR] 1.13, 95% CI 1.11 to 1.15, p <0.001). Patients with COPD were more likely to develop new-onset heart failure (AOR 2.01, 95% CI 1.99 to 2.03), cardiogenic shock (AOR 1.24, 95% CI 1.22 to 1.26), and acute respiratory failure (AOR 2.46, 95% CI 2.43 to 2.50) during their hospital stay. Patients with COPD were less likely to undergo diagnostic angiographies and any revascularization procedures. The mean length of stay (6.0 vs 4.6 days; p <0.001) was greater in patients with COPD, as were hospital average hospital charges ($63,956 vs $58,536; p <0.001). In conclusion, among patients with STEMI, COPD is associated with a greater risk of in-hospital mortality, new-onset heart failure, acute respiratory failure, and cardiogenic shock.

Original languageEnglish (US)
Pages (from-to)1555-1559
Number of pages5
JournalAmerican Journal of Cardiology
Volume119
Issue number10
DOIs
StatePublished - May 15 2017

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Hospital Mortality
Chronic Obstructive Pulmonary Disease
Odds Ratio
Cardiogenic Shock
Respiratory Insufficiency
Inpatients
Length of Stay
Heart Failure
ST Elevation Myocardial Infarction
Hospital Charges
Obstructive Lung Diseases
Medicare
Insurance
Social Class
Angiography
Multivariate Analysis
Databases
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of Chronic Obstructive Pulmonary Disease on In-Hospital Mortality and Clinical Outcomes After ST-Segment Elevation Myocardial Infarction. / Agarwal, Manyoo; Agrawal, Sahil; Garg, Lohit; Garg, Aakash; Bhatia, Nirmanmoh; Kadaria, Dipen; Reed, Guy.

In: American Journal of Cardiology, Vol. 119, No. 10, 15.05.2017, p. 1555-1559.

Research output: Contribution to journalArticle

Agarwal, Manyoo ; Agrawal, Sahil ; Garg, Lohit ; Garg, Aakash ; Bhatia, Nirmanmoh ; Kadaria, Dipen ; Reed, Guy. / Effect of Chronic Obstructive Pulmonary Disease on In-Hospital Mortality and Clinical Outcomes After ST-Segment Elevation Myocardial Infarction. In: American Journal of Cardiology. 2017 ; Vol. 119, No. 10. pp. 1555-1559.
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