2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.
2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
PLoS One. 2018 Oct 1;13(10):e0204257. doi: 10.1371/journal.pone.0204257. eCollection 2018.
The relationship between chronic obstructive pulmonary disease (COPD) and periprocedural complications of percutaneous coronary interventions (PCIs) is influenced by several factors. We aimed to investigate the association between COPD, its complication type and rate in patients undergoing PCI.
Data were prospectively collected using the Polish Cardiovascular Intervention Society national registry (ORPKI) on all PCIs performed in Poland between January 2015 and December 2016. COPD was present in 5,594 of the 221,187 patients undergoing PCI. We assessed the frequency and predictors of periprocedural complications in PCI.
Patients with COPD were elder individuals (70.3 ± 9.9 vs. 67 ± 10.8 years; p < 0.05). We noted 145 (2.6%) periprocedural complications in the COPD group and 4,121 (1.9%) in the non-COPD group (p < 0.001). The higher incidence of periprocedural complications in the COPD patients was mainly attributed to cardiac arrest (p = 0.001), myocardial infarctions (p = 0.002) and no-reflows (p < 0.001). COPD was not an independent predictor of all periprocedural complications. On the other hand, COPD was found to be an independent predictor of increased no-reflow risk (odds ratio [OR] 1.447, 95% CI 1.085-1.929; p = 0.01), and at the same time, of decreased risk of periprocedural allergic reactions (OR 0.117, 95% CI 0.016-0.837; p = 0.03).
In conclusion, periprocedural complications of PCIs are more frequent in patients with COPD. COPD is an independent positive predictor of no-reflow and a negative predictor of periprocedural allergic reactions.
慢性阻塞性肺疾病（COPD）与经皮冠状动脉介入治疗（PCI）围手术期并发症之间的关系受多种因素影响。我们旨在研究 COPD 及其在接受 PCI 治疗的患者中的并发症类型和发生率之间的关联。
使用波兰心血管介入学会全国登记处（ORPKI）前瞻性收集了 2015 年 1 月至 2016 年 12 月期间在波兰进行的所有 PCI 数据。在接受 PCI 的 221187 名患者中，有 5594 名患有 COPD。我们评估了 PCI 围手术期并发症的发生率和预测因素。
COPD 患者为年龄较大的个体（70.3±9.9 岁 vs. 67±10.8 岁；p<0.05）。我们在 COPD 组中发现了 145 例（2.6%）围手术期并发症，在非 COPD 组中发现了 4121 例（1.9%）（p<0.001）。COPD 患者围手术期并发症发生率较高，主要归因于心脏骤停（p=0.001）、心肌梗死（p=0.002）和无复流（p<0.001）。COPD 不是所有围手术期并发症的独立预测因素。另一方面，COPD 被发现是无复流风险增加的独立预测因素（优势比[OR]1.447，95%置信区间 1.085-1.929；p=0.01），同时也是围手术期过敏反应风险降低的独立预测因素（OR 0.117，95%置信区间 0.016-0.837；p=0.03）。
总之，PCI 围手术期并发症在 COPD 患者中更为常见。COPD 是无复流的独立正预测因子，也是围手术期过敏反应的负预测因子。
