Impact of chronic obstructive pulmonary disease on 10-year mortality after percutaneous coronary intervention and bypass surgery for complex coronary artery disease: insights from the SYNTAX Extended Survival study

Francesco Burzotta, Sergio Berti, Rutao Wang, Mariusz Tomaniak, Kuniaki Takahashi, Chao Gao, Hideyuki Kawashima, Hironori Hara, Masafumi Ono, David van Klaveren, Robert-Jan van Geuns, Marie-Claude Morice, Piroze M Davierwala, Michael J Mack, Adam Witkowski, Nick Curzen, Stefan James, Arie Pieter Kappetein, Stuart J Head, Daniel J F M ThuijsFriedrich W Mohr, David R Holmes, Ling Tao, Yoshinobu Onuma, Patrick W Serruys

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

AIMS: To evaluate the impact of chronic obstructive pulmonary disease (COPD) on 10-year all-cause death and the treatment effect of CABG versus PCI on 10-year all-cause death in patients with three-vessel disease (3VD) and/or left main coronary artery disease (LMCAD) and COPD.METHODS: Patients were stratified according to COPD status and compared with regard to clinical outcomes. Ten-year all-cause death was examined according to the presence of COPD and the revascularization strategy.RESULTS: COPD status was available for all randomized 1800 patients, of whom, 154 had COPD (8.6%) at the time of randomization. Regardless of the revascularization strategy, patients with COPD had a higher risk of 10-year all-cause death, compared with those without COPD (43.1% vs. 24.9%; hazard ratio [HR]: 2.03; 95% confidence interval [CI]: 1.56-2.64; p<0.001). Among patients with COPD, CABG appeared to have a slightly lower risk of 10-year all-cause death compared with PCI (42.3% vs. 43.9%; HR: 0.96; 95% CI: 0.59-1.56, p=0.858), whereas among those without COPD, CABG had a significantly lower risk of 10-year all-cause death (22.7% vs. 27.1%; HR: 0.81; 95% CI: 0.67-0.99, p=0.041). There was no significant differential treatment effect of CABG versus PCI on 10-year all-cause death between patients with and without COPD (p interaction=0.544).CONCLUSIONS: COPD was associated with a higher risk of 10-year all-cause death after revascularization for complex coronary artery disease. The presence of COPD did not significantly modify the beneficial effect of CABG versus PCI on 10-year all-cause death.TRIAL REGISTRATION: SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaClinical Research in Cardiology
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • All-cause death
  • Chronic obstructive pulmonary disease
  • Coronary artery bypass grafting
  • Percutaneous coronary intervention
  • SYNTAX

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