title: Impact of COPD on long-term outcome after ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention.
abstract: BACKGROUND
  There are limited data describing the long-term outcome of patients with concomitant COPD who develop ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  A total of 11,118 consecutive patients with STEMI enrolled in the web-based Registro Regionale Angioplastiche Emilia-Romagna (REAL) registry were followed-up and stratified according to COPD presence or not. At 3-year follow-up, mortality and hospital readmissions due to myocardial infarction (MI), heart failure (HF), coronary revascularization (CR), serious bleeding, and COPD were assessed.
  
  
  RESULTS
  According to our criteria, 2,032 patients (18.2%) had a diagnosis of COPD. Overall, 1,829 patients (16.5%) died. COPD was an independent predictor of mortality (hazard ratio [HR], 1.4; 95% CI, 1.2-1.6). Hospital readmissions for recurrent MI (10% vs 6.9%, P &lt; .01), CR (22% vs 19%, P &lt; .01), HF (10% vs 6.9%, P &lt; .01), and SB (10% vs 6%, P &lt; .01) were significantly more frequent in patients with COPD as compared with those without. Also, hospital readmissions for COPD were more frequent in patients with a previous history of COPD as compared with those without (19% vs 3%; P &lt; .01, respectively). Patients with a hospital readmission for COPD showed a fourfold increased risk of death (HR, 4.2; 95% CI, 3.4-5.2). Finally, hospital readmissions for COPD emerged as a strong independent risk factor for recurrence of MI (HR, 2.1; 95% CI, 1.4-3.3), HF (HR, 5.8; 95% CI, 4.6-7.5), and SB (HR, 3; 95% CI, 2.1-4.4).
  
  
  CONCLUSIONS
  Patients with STEMI and concomitant COPD are at greater risk for death and hospital readmissions due to cardiovascular causes (eg, recurrent MI, HF, bleedings) than patients without COPD.
authors: Cardiovascular Institute, Azienda Ospedaliero-Universitaria S.Anna, Ferrara; LTTA center, Ferrara. Electronic address: cmpglc@unife.it.
authors: Gianluca
authors: G
authors: Campo
authors: Agenzia Sanitaria Regionale Regione Emilia-Romagna, Bologna.
authors: Paolo
authors: P
authors: Guastaroba
authors: Istituto di Cardiologia, Università di Bologna, Policlinico S. Orsola-Malpighi, Bologna.
authors: Antonio
authors: A
authors: Marzocchi
authors: Unità Operativa di Cardiologia, Ospedale degli Infermi, Rimini.
authors: Andrea
authors: A
authors: Santarelli
authors: Unità Operativa di Cardiologia, Ospedale S. Maria delle Croci, Ravenna.
authors: Elisabetta
authors: E
authors: Varani
authors: Divisione di Cardiologia, Ospedale Maggiore, Parma.
authors: Luigi
authors: L
authors: Vignali
authors: Unità Operativa di Cardiologia, Ospedale Maggiore, Bologna.
authors: Pietro
authors: P
authors: Sangiorgio
authors: Unità Operativa di Cardiologia, Ospedale di Baggiovara, Modena.
authors: Stefano
authors: S
authors: Tondi
authors: Dipartimento Cure Primarie, Azienda Sanitaria Locale di Ferrara, Ferrara, Italy.
authors: Carlotta
authors: C
authors: Serenelli
authors: Agenzia Sanitaria Regionale Regione Emilia-Romagna, Bologna.
authors: Rossana
authors: R
authors: De Palma
authors: Istituto di Cardiologia, Università di Bologna, Policlinico S. Orsola-Malpighi, Bologna.
authors: Francesco
authors: F
authors: Saia
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000601:surgery*; D010359:Patient Readmission / Q000706:statistics & numerical data; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors