Author + information
- Francois Schiele,
- Etienne Puymirat,
- Nicolas Meneveau,
- Simon Cattan,
- Francois Xavier Soto,
- Patrick Henry,
- Bernard Livarek,
- Didier Blanchard,
- Jean Ferrieres,
- Tabassome Simon and
- Nicolas Danchin
Chronic Pulmonary Disease (CPD) is commonly considered as a co morbidity in patients with Acute Myocardial Infarction (AMI), but its impact on acute management and outcome after AMI is poorly documented. Using data from the multicenter nationwide registry FAST-MI 2005, we determined the impact of history of CPD on the use of strategies and treatments duringacute hospitalization and on 5 year survival.
FAST-MI 2005 included consecutive patients with AMI over 1 month in 223 French centres. Baseline characteristics, management and 5 year survival were compared between groups according to CPD status. Multivariate regression was used to determine the impact on in-hospital management in patients with vs without CPD, adjusted for baseline characteristics and treatments.
Among 3670 patients included, 95% had complete follow-up at 5 years and 179(4.9%) had a history of CPD. CPD pts were on average 5 years older, had more diabetes, hypertension, previous MI, stroke, heart and renal failure and higher GRACE score. They less often received dual antiplatelet, clopidogrel and betablockers. In-hospital death was twice as high in CPD patients (12.8% vs 5.2%, p<0.0001), as was 5 year mortality (58.1% vs 27.8%), p<0.001). Adjusted for baseline characteristics, comorbidities and conditions at admission, CPD was associated with long term mortality (OR 2.1 [1.4; 3.0]).
CPD patients represent a high risk subgroup for early and long term death, irrespective of associated comorbidities.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Comorbidity and ACS: COPD, Renal Dysfunction, Diabetes
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1257-185
- 2013 American College of Cardiology Foundation