Impact of chronic obstructive pulmonary disease on short-term outcome in patients with ST-elevation myocardial infarction during COVID-19 pandemic: insights from the international multicenter ISACS-STEMI registry

Respiratory Research - Tập 23 - Trang 1-9 - 2022
Giuseppe De Luca1,2, Matteo Nardin3, Magdy Algowhary4, Berat Uguz5, Dinaldo C. Oliveira6, Vladimir Ganyukov7, Zan Zimbakov8, Miha Cercek9, Lisette Okkels Jensen10, Poay Huan Loh11, Lucian Calmac12, Gerard Roura Ferrer13, Alexandre Quadros14, Marek Milewski15, Fortunato Scotto di Uccio16, Clemens von Birgelen17, Francesco Versaci18, Jurrien Ten Berg19, Gianni Casella20, Aaron Wong Sung Lung21, Petr Kala22, José Luis Díez Gil23, Xavier Carrillo24, Maurits Dirksen25, Victor M. Becerra-Munoz26, Michael Kang-yin Lee27, Dafsah Arifa Juzar28, Rodrigo de Moura Joaquim29, Roberto Paladino30, Davor Milicic31, Periklis Davlouros32, Nikola Bakraceski33, Filippo Zilio34, Luca Donazzan35, Adriaan Kraaijeveld36, Gennaro Galasso37, Arpad Lux38, Lucia Marinucci39, Vincenzo Guiducci40, Maurizio Menichelli41, Alessandra Scoccia42, Aylin Hatice Yamac43, Kadir Ugur Mert44, Xacobe Flores Rios45, Tomas Kovarnik46, Michal Kidawa47, Josè Moreu48, Vincent Flavien49, Enrico Fabris50, Iñigo Lozano Martínez-Luengas51, Marco Boccalatte52, Francisco Bosa Ojeda53, Carlos Arellano-Serrano54, Gianluca Caiazzo55, Giuseppe Cirrincione56, Hsien-Li Kao57, Juan Sanchis Forés58, Luigi Vignali59, Helder Pereira60, Stephane Manzo61, Santiago Ordoñez62, Alev Arat Özkan63, Bruno Scheller64, Heidi Lehtola65, Rui Teles66, Christos Mantis67, Ylitalo Antti68, João A. Brum Silveira69, Rodrigo Zoni70, Ivan Bessonov71, Stefano Savonitto72, George Kochiadakis73, Dimitrios Alexopoulos74, Carlos E. Uribe75, John Kanakakis76, Benjamin Faurie77, Gabriele Gabrielli78, Alejandro Gutierrez Barrios79, Juan Pablo Bachini80, Alex Rocha81, Frankie Chor-Cheung Tam82, Alfredo Rodriguez83, Antonia Anna Lukito84, Veauthyelau Saint-Joy85, Gustavo Pessah86, Andrea Tuccillo16, Giuliana Cortese87, Guido Parodi88, Mohamed Abed Bouraghda89, Elvin Kedhi90, Pablo Lamelas62, Harry Suryapranata91, Monica Verdoia92
1Division of Clinical and Experimental Cardiology, AOU Sassari, Sassari, Italy
2University of Sassari, Sassari, Italy
3Third Medicine Division, ASST Spedali Civili, Brescia, Italy
4Division of Cardiology, Assiut University Heart Hospital, Assiut University, Asyut, Egypt
5Division of Cardiology, Bursa City Hospital, Bursa, Turkey
6Pronto de Socorro Cardiologico Prof. Luis Tavares, Centro PROCAPE, Federal University of Pernambuco, Recife, Brazil
7Department of Heart and Vascular Surgery, State Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
8Medical Faculty, University Clinic for Cardiology, Ss’ Cyril and Methodius University, Skopje, North Macedonia
9Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia
10Division of Cardiology, Odense Universitets Hospital, Odense, Danemark
11Department of Cardiology, National University Hospital, Singapore, Singapore
12Clinic Emergency Hospital of Bucharest, Bucharest, Romania
13Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, Barcelona, Spain
14Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, Brazil
15Division of Cardiology, Medical University of Silezia, Katowice, Poland
16Division of Cardiology, Ospedale del Mare, Naples, Italy
17Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, The Netherlands
18Division of Cardiology, Ospedale Santa Maria Goretti Latina, Latina, Italy
19Division of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands
20Division of Cardiology, Ospedale Maggiore Bologna, Bologna, Italy
21Department of Cardiology, National Heart Center, Singapore, Singapore
22University Hospital Brno, Medical Faculty of Masaryk University, Brno, Czech Republic
23H. Universitario y Politécnico La Fe, Valencia, Spain
24Hospital Germans Triasi Pujol, Badalona, Spain
25Division of Cardiology, Northwest Clinics, Alkmaar, The Netherlands
26Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
27Department of Cardiology, Queen Elizabeth Hospital, University of Hong Kong, Yau Ma Tei, Hong Kong
28Department of Cardiology and Vascular Medicine, University of Indonesia National Cardiovascular Center “Harapan Kita”, Jakarta, Indonesia
29Instituto de Cardiologia de Santa Catarina Praia Comprida, São José, Brasil
30Division of Cardiology, Clinica Villa dei Fiori, Acerra, Italy
31Department of Cardiology, University Hospital Centre, University of Zagreb, Zagreb, Croatia
32Invasive Cardiology and Congenital Heart Disease, Patras University Hospital, Patras, Greece
33Center for Cardiovascular Diseases, Ohrid, North Macedonia
34Division of Cardiology, Ospedale Santa Chiara di Trento, Trento, Italy
35Division of Cardiology, Ospedale “S. Maurizio” Bolzano, Bolzano, Italy
36Division of Cardiology, UMC Utrecht, Utrecht, The Netherlands
37Division of Cardiology, Ospedale San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
38Maastricht University Medical Center, Maastricht, The Netherlands
39Division of Cardiology, Azienda Ospedaliera “Ospedali Riuniti Marche Nord”, Pesaro, Italy
40Division of Cardiology, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
41Division of Cardiology, Ospedale “F. Spaziani”, Frosinone, Italy
42Division of Cardiology, Ospedale “Sant’Anna”, Ferrara, Italy
43Department of Cardiology, Hospital Bezmialem Vakıf University, İstanbul, Turkey
44Division of Cardiology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
45Complexo Hospetaliero Universitario La Coruna, La Coruna, Spain
46University Hospital Prague, Prague, Czech Republic
47Central Hospital of Medical University of Lodz, Lodz, Poland
48Division of Cardiology, Complejo Hospitalario de Toledo, Toledo, Spain
49Division of Cardiology, Center Hospitalier Universitaire de Lille, Lille, France
50Azienda Ospedaliero-Universitaria Ospedali Riuniti Trieste, Trieste, Italy
51Division of Cardiology, Hospital Cabueñes, Gijon, Spain
52Division of Cardiology, Ospedale Santa Maria delle Grazie, Pozzuoli, Italy
53Division of Cardiology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
54Division of Cardiology, Hospital Puerta de Hierro Majadahonda, Madrid, Spain
55Division of Cardiology, Ospedale “G Moscati”, Aversa, Italy
56Division of Cardiology, Ospedale Civico Arnas, Palermo, Italy
57Cardiology Division, Department of Internal Medicine, National Taiwan University Hospital, Tapei, Taiwan
58Division of Cardiology, Hospital Clinico Universitario de Valencia, Valencia, Spain
59Interventional Cardiology Unit, Azienda Ospedaliera Sanitaria, Parma, Italy
60Cardiology Department, Hospital Garcia de Orta, Almada, Portugal
61Division of Cardiology, CHU Lariboisière, AP-HP, Paris VII University, INSERM UMRS 942, Paris, France
62Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
63Cardiology Institute, Istanbul University, Istanbul, Turkey
64Division of Cardiology Clinical and Experimental Interventional Cardiology, University of Saarland, Saarbrücken, Germany
65Division of Cardiology, Oulu University Hospital, Oulu, Finland
66Division of Cardiology, Hospital de Santa Cruz, CHLO-Nova Medical School, CEDOC, Lisbon, Portugal
67Division of Cardiology, Kontantopoulion Hospital, Athens, Greece
68Division of Cardiology, Heart Centre Turku, Turku, Finland
69Division of Cardiology, Hospital de Santo António, Porto, Portugal
70Department of Teaching and Research, Instituto de Cardiología de Corrientes “Juana F. Cabral”, Corrientes, Argentina
71Tyumen Cardiology Research Center, Tyumen, Russia
72Division of Cardiology, Ospedale “A. Manzoni”, Lecco, Italy
73Iraklion University Hospital, Crete, Greece
74Division of Cardiology, Attikon University Hospital, Athens, Greece
75Division of Cardiology, Universidad UPB, Universidad CES, Medellin, Colombia
76Division of Cardiology, Alexandra Hospital, Athens, Greece
77Division of Cardiology, Groupe Hospitalier Mutualiste de Grenoble, Grenoble, France
78Interventional Cardiology Unit, Azienda Ospedaliero Universitaria “Ospedali Riuniti”, Ancona, Italy
79Division of Cardiology, Hospital Puerta del Mar, Cadiz, Spain
80Instituto de Cardiologia Integral, Montevideo, Uruguay
81Department of Cardiology and Cardiovascular Interventions, Instituto Nacional de Cirugía Cardíaca, Montevideo, Uruguay
82Department of Cardiology, Queen Mary Hospital, University of Hong Kong, Pok Fu Lam, Hong Kong
83Division of Cardiology, Otamendi Hospital, Buenos Aires, Argentina
84Cardiovascular Department Pelita, Harapan University/Heart Center Siloam Lippo Village Hospital, Tangerang, Indonesia
85Center Hospitalier d’Antibes Juan Les Pins, Antibes, France
86Division of Cardiology, Hospiatl Cordoba, Cordoba, Argentina
87Department of Statistical Sciences, University of Padova, Padua, Italy
88Department of Cardiology, ASL 4 Liguria, Lavagna, Italy
89Division of Cardiology, Blida University Hospital, Blida, Algeria
90Division of Cardiology, Hopital Erasmus, Universitè Libre de Bruxelles, Brussels, Belgium
91Division of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
92Division of Cardiology, Ospedale degli Infermi, ASL Biella, Ponderano, Italy

Tóm tắt

Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclerosis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocardial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study. In the ISACS-STEMI COVID-19 registry we included retrospectively patients with STEMI treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 from 109 high-volume primary PCI centers in 4 continents. A total of 15,686 patients were included in this analysis. Of them, 810 (5.2%) subjects had a COPD diagnosis. They were more often elderly and with a more pronounced cardiovascular risk profile. No preminent procedural dissimilarities were noticed except for a lower proportion of dual antiplatelet therapy at discharge among COPD patients (98.9% vs. 98.1%, P = 0.038). With regards to short-term fatal outcomes, both in-hospital and 30-days mortality occurred more frequently among COPD patients, similarly in pre-COVID-19 and COVID-19 era. However, after adjustment for main baseline differences, COPD did not result as independent predictor for in-hospital death (adjusted OR [95% CI] = 0.913[0.658–1.266], P = 0.585) nor for 30-days mortality (adjusted OR [95% CI] = 0.850 [0.620–1.164], P = 0.310). No significant differences were detected in terms of SARS-CoV-2 positivity between the two groups. This is one of the largest studies investigating characteristics and outcome of COPD patients with STEMI undergoing primary angioplasty, especially during COVID pandemic. COPD was associated with significantly higher rates of in-hospital and 30-days mortality. However, this association disappeared after adjustment for baseline characteristics. Furthermore, COPD did not significantly affect SARS-CoV-2 positivity. Trial registration number: NCT 04412655 (2nd June 2020).

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