Impact of Chronic Obstructive Pulmonary Disease on Heart Failure Hospitalizations After an Acute Myocardial Infarction

Authors

Srikanth Yandrapalli, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Maya Pandit, New York Medical College, Valhalla, NY, USA.Follow
Aaqib Malik, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
Kanika Gupta, Department of Medicine, Tulane University, New Orleans, LA, USA.
Christopher Nabors, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
Diwakar Jain, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
William Frishman, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow
Wilbert S. Aronow, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.Follow

Author Type(s)

Student, Faculty

DOI

10.5114/amsad/162014

Journal Title

Archives of Medical Sciences. Atherosclerotic Diseases

First Page

e35

Last Page

e43

Document Type

Article

Publication Date

1-1-2023

Department

Medicine

Abstract

INTRODUCTION: The presence of chronic obstructive pulmonary disease (COPD) can impact the management of acute myocardial infarction (AMI) and is associated with higher mortality. Few studies addressed COPD impact on heart failure hospitalisations (HFHs) in AMI survivors. MATERIAL AND METHODS: Adult survivors of an AMI between January and June 2014 were identified from the US Nationwide Readmissions Database. The impact of COPD on HFH within 6 months, fatal HFH and the composite of in-hospital HF or 6-month HFH was studied. RESULTS: Of 237,549 AMI survivors, patients with COPD (17.5%) were older, more likely female, had a higher prevalence of cardiac comorbidities and a lower coronary revascularization rate. In-hospital HF was more frequent in patients with COPD (47.0% vs. 25.4%; < 0.001). HFH within 6 months occured in 12,934 (5.4%) patients, at a 114% higher rate in patients with COPD (9.4% vs. 4.6%, OR = 2.14, 95% CI : 2.01-2.29; < 0.001), which was attenuated to a 39% higher adjusted risk (OR = 1.39, 95% CI: 1.30-1.49). Findings were consistent across subgroups of age, AMI type, and major HF risk factors. Mortality during a HFH (5.7% vs. 4.2%, < 0.001) and the rate of the composite HF outcome (49.0% vs. 26.9%, < 0.001) were significantly higher in patients with COPD. CONCLUSIONS: COPD was present in 1 of 6 AMI survivors and was associated with worse HF related outcomes. The increased HFH rate in COPD patients was consistent across several clinically relevant subgroups and these findings highlight the need for optimal in-hospital and post-discharge management of these higher-risk patients.

Recommended Citation

Yandrapalli, S., Pandit, M., Malik, A., Gupta, K., Nabors, C., Jain, D., Frishman, W., & Aronow, W. S. (2023). Impact of Chronic Obstructive Pulmonary Disease on Heart Failure Hospitalizations After an Acute Myocardial Infarction. Archives of Medical Sciences. Atherosclerotic Diseases, 8, e35-e43. https://doi.org/10.5114/amsad/162014