scholarly journals Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions

Author(s):  
Rafał Januszek ◽  
Zbigniew Siudak ◽  
Artur Dziewierz ◽  
Tomasz Rakowski ◽  
Dariusz Dudek ◽  
...  
2019 ◽  
Vol 10 (4) ◽  
pp. 6-11
Author(s):  
Vitalii K. Zafiraki ◽  
Konstantin V. Skaletsky ◽  
Elena D. Kosmacheva

Aim. To assess the influence of concomitant chronic obstructive pulmonary disease (COPD) on the frequency of repeat myocardial revascularization in patients with coronary artery disease (CAD) after percutaneous coronary interventions (PCI), as well as to determine independent predictors of repeat revascularization in patients with concominant COPD. Materials and methods. A prospective cohort study included 646 patients with CAD, of which 254 had concominant COPD. All patients underwent PCI (46.9% for acute coronary syndrome in the main group and 44.9% in the control group. Remaining interventions were elective). The frequency of repeat myocardial revascularization and the time till re-intervention was registered during the follow-up period up to 36 months. Results. COPD increases risk of repeat myocardial revascularization (hazard ratio - HR 1.46; 95% confidence interval - CI 1.03-2.06), repeat PCI (HR 1.62; 95% CI 1.03-2.32) and is accompanied by an earlier onset of re-intervention. An independent predictors of repeat myocardial revascularization in the Cox regression model are: glomerular filtration rate (p=0.001), ankle-brachial index (p=0.004), frequent exacerbations of COPD (p=0.028), total number of coronary artery stenosis (p=0.039) and blood concentration of C-reactive protein (p=0.066). Conclusions. COPD is a significant risk factor of re-intervention after PCI in patients with acute and chronic forms of CAD and leads to its earlier performing. The patients with frequent COPD exacerbations have the highest risk of repeat myocardial revascularization during follow-up.


2017 ◽  
Vol 117 (06) ◽  
pp. 1208-1216 ◽  
Author(s):  
Gianluca Campo ◽  
Francesco Vieceli Dalla Sega ◽  
Rita Pavasini ◽  
Giorgio Aquila ◽  
Francesco Gallo ◽  
...  

SummaryPatients with SCAD and concomitant COPD are at high risk of cardiovascular adverse events, due to chronic inflammation, responsible of endothelial dysfunction, oxidative stress and heightened platelet reactivity (PR). The objective of this randomised clinical trial was to test if ticagrelor is superior to clopidogrel in improving endothelial function in patients with stable coronary artery disease (SCAD) and concomitant chronic obstructive pulmonary disease (COPD). Forty-six patients with SCAD and COPD undergoing percutaneous coronary intervention (PCI) were randomly assigned to receive clopidogrel (n=23) or ticagrelor (n=23) on top of standard therapy with aspirin. The following parameters were assessed at baseline and after 1 month: i) rate of apoptosis and ii) nitric oxide (NO) levels in human umbilical vein endothelial cells (HUVECs), iii) levels of reactive oxygen species (ROS) in peripheral blood mononuclear cell, iv) 29 cytokines/chemokines, v) on-treatment PR. The primary endpoint of the study was the 1-month rate of HUVECs apoptosis. The rate of apoptosis after 1 month was significantly lower in patients treated with ticagrelor (7.4 ± 1.3% vs 9.3 ± 1.5%, p<0.001), satisfying the pre-specified primary endpoint. In the ticagrelor arm, levels of NO were higher (10.1 ± 2.2 AU vs 8.5 ± 2.6 AU, p=0.03) while those of ROS (4 ± 1.8 AU vs 5.7 ± 2.8 AU, p=0.02) and P2Y12 reactivity units (52 ± 70 PRU vs 155 ± 62 PRU, p<0.001) were lower. There were no differences in cytokines/chemokines levels and aspirin reactivity units between groups. In patients with SCAD and COPD undergoing PCI, ticagrelor, as compared to clopidogrel is superior in improving surrogate markers of endothelial function and on-treatment PR (ClinicalTrials.gov, NCT02519608).Supplementary Material to this article is available online at www.thrombosis-online.com.


2014 ◽  
Vol 13 (5) ◽  
pp. 04-07
Author(s):  
Sonkamble Siddharth ◽  
◽  
Sangeeta Pednekar ◽  
R. H. Girde ◽  
Shilpa Patil ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document