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

Fecha de publicación: 15/08/2022 Fecha Ahead of Print: 15/08/2022

Autores de IIS La Fe

José Luis Díez Gil

Autor

Participantes ajenos a IIS La Fe

De Luca, Giuseppe
Nardin, Matteo
Algowhary, Magdy
Uguz, Berat
Oliveira, Dinaldo C.
Ganyukov, Vladimir
Zimbakov, Zan
Cercek, Miha
Okkels Jensen, Lisette
Loh, Poay Huan
Calmac, Lucian
Roura Ferrer, Gerard
Quadros, Alexandre
Milewski, Marek
Scotto di Uccio, Fortunato
von Birgelen, Clemens
Versaci, Francesco
Ten Berg, Jurrien
Casella, Gianni
Wong Sung Lung, Aaron
Kala, Petr
Carrillo, Xavier
Dirksen, Maurits
Becerra-Munoz, Victor M.
Lee, Michael Kang-yin
Arifa Juzar, Dafsah
de Moura Joaquim, Rodrigo
Paladino, Roberto
Milicic, Davor
Davlouros, Periklis
Bakraceski, Nikola
Zilio, Filippo
Donazzan, Luca
Kraaijeveld, Adriaan
Galasso, Gennaro
Lux, Arpad
Marinucci, Lucia
Guiducci, Vincenzo
Menichelli, Maurizio
Scoccia, Alessandra
Yamac, Aylin Hatice
Ugur Mert, Kadir
Flores Rios, Xacobe
Kovarnik, Tomas
Kidawa, Michal
Moreu, Jose
Flavien, Vincent
Fabris, Enrico
Martinez-Luengas, Inigo Lozano
Boccalatte, Marco
Bosa Ojeda, Francisco
Arellano-Serrano, Carlos
Caiazzo, Gianluca
Cirrincione, Giuseppe
Kao, Hsien-Li
Sanchis Fores, Juan
Vignali, Luigi
Pereira, Helder
Manzo, Stephane
Ordonez, Santiago
Ozkan, Alev Arat
Scheller, Bruno
Lehtola, Heidi
Teles, Rui
Mantis, Christos
Antti, Ylitalo
Brum Silveira, Joao A.
Zoni, Rodrigo
Bessonov, Ivan
Savonitto, Stefano
Kochiadakis, George
Alexopoulos, Dimitrios
Uribe, Carlos E.
Kanakakis, John
Faurie, Benjamin
Gabrielli, Gabriele
Gutierrez Barrios, Alejandro
Bachini, Juan Pablo
Rocha, Alex
Tam, Frankie Chor-Cheung
Rodriguez, Alfredo
Lukito, Antonia Anna
Saint-Joy, Veauthyelau
Pessah, Gustavo
Tuccillo, Andrea
Cortese, Giuliana
Parodi, Guido
Bouraghda, Mohamed Abed
Kedhi, Elvin
Lamelas, Pablo
Suryapranata, Harry
Verdoia, Monica

Grupos

Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí

Abstract

Background 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. Methods 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. Results 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. Conclusion 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).