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[长期经皮冠状动脉介入治疗结果方面频繁加重的慢性阻塞性肺疾病的表型]

[The Phenotype of Chronic Obstructive Pulmonary Disease With Frequent Exacerbations in the Aspect of Long-term Percutaneous Coronary Intervention Results].

作者信息

Zafiraki V K, Namitokov A M, Skaletsky K V, Kosmacheva E D, Shulzhenko L V, Ramazanov J M, Omarov A A, Pershukov I V

机构信息

Kuban State Medical University, Krasnodar, Russia.

Central Hospital of Oilworkers, Baku, Azerbaijan.

出版信息

Kardiologiia. 2017 Mar;57(3):51-57.

PMID:28762936
Abstract

OBJECTIVE

To evaluate the results of percutaneous coronary interventions (PCI) in patients with coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD), depending on the frequency of exacerbations of COPD.

MATERIALS AND METHODS

We enrolled in this prospective study 103 patients with CHD and COPD who underwent PCI (n=103) including 25 who satisfied criteria of COPD phenotype with frequent exacerbations (main group). Analysis included comparison of rates and times to major adverse cardiac events (MACE - myocardial infarction, stroke, cardiac death, repeat revascularization) in the main group and other patients. Clinical and functional features of patients with major adverse cardiac events were also analyzed.

RESULTS

Study groups did not differ significantly on demographic characteristics and the presence of comorbidity. MACE frequency was almost 2 times higher in the main group (relative risk 1.87; 95% confidence interval (CI) 1.1-3.3). There was a tendency to higher rate of MACE among patients with history of more or equal 1 COPD exacerbations in a year (40% vs. 24%, p=0.09). The following clinical and functional characteristics of COPD, were associated with MACE in remote period after PCI: frequency of exacerbations, results of the COPD Assessment Test, exercise capacity, forced expiratory volume in 1 sec. Conclusion/ COPD phenotype with frequent exacerbations in patients with CHD undergoing PCI is associated with increased risk and earlier occurrence of MACE.

摘要

目的

根据慢性阻塞性肺疾病(COPD)的加重频率,评估冠心病(CHD)合并COPD患者经皮冠状动脉介入治疗(PCI)的结果。

材料与方法

我们纳入了103例接受PCI治疗的CHD合并COPD患者(n = 103),其中25例符合COPD频繁加重表型标准(主要组)。分析包括比较主要组和其他患者发生主要不良心脏事件(MACE - 心肌梗死、中风、心源性死亡、再次血运重建)的发生率和时间。还分析了发生主要不良心脏事件患者的临床和功能特征。

结果

研究组在人口统计学特征和合并症存在方面无显著差异。主要组的MACE发生率几乎高出2倍(相对风险1.87;95%置信区间(CI)1.1 - 3.3)。一年中发生1次或更多次COPD加重病史患者中的MACE发生率有升高趋势(40%对24%,p = 0.09)。PCI术后远期,以下COPD的临床和功能特征与MACE相关:加重频率、COPD评估测试结果、运动能力、第1秒用力呼气量。结论/接受PCI的CHD患者中频繁加重的COPD表型与MACE风险增加和更早发生相关。

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