There are limited data regarding contemporary trends in management and outcomes of patients with COPD who develop acute myocardial infarction (AMI). The objective of this populationbased study was to describe the management and shortterm outcomes among patients with AMI with and without COPD between 1997 and 2007.
The study population consisted of patients hospitalized with AMI at all greater Worcester (MA) medical centers between 1997 and 2007.
Of the 6,290 patients hospitalized with AMI, 17% had history of COPD. Patients with COPD were less likely to be treated with betablockers, lipid lowering therapy and have undergone interventional procedures. They were at higher risk for dying during hospitalization (13.5% vs. 10.1%), and at 30 days (18.7% vs. 13.2%) and their outcomes did not improve during the decade long period of this study. After multivariable adjustment, the adverse effects of COPD remained on both inhospital (OR: 1.25, 95% CI: 0.991.50) and 30day allcause mortality (OR: 1.31, 95% CI: 1.101.58). As expected, the use of all evidencebased therapies for all patients with AMI increased between 1997 and 2007, with a particularly marked increase for patients with COPD.
Our results suggest that the gap in care quality between patients with and without COPD hospitalized with AMI closed substantially between 1997 and 2007 but patients with COPD are still less aggressively treated and they at increased risk for hospital adverse outcomes. Careful consideration is necessary to ensure that these high risk complex patients are not denied the benefits of effective cardiac therapies.
To cite this abstract:Lessard D, Stefan M, Lindenauer P, Bannuru R, Goldberg R. The Impact of Copd on Management and Outcomes of Patients Hospitalized with Acute Myocardial Infarction; a Tenyear Retrospective Observational Study. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97640. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/the-impact-of-copd-on-management-and-outcomes-of-patients-hospitalized-with-acute-myocardial-infarction-a-tenyear-retrospective-observational-study/. Accessed January 23, 2020.