Impact of chronic obstructive pulmonary disease on short-term outcome in patients with ST-elevation myocardial infarction during COVID-19 pandemic
Year: 2026
Type: article
Abstract: Background: Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclero‑ sis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocar‑ dial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study. Methods: In the ISACS-STEMI COVID-19 registry we included retrospectively patients with STEMI treated with pri‑ mary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 from 109 high-volume primary PCI centers in 4 continents. Results: A total of 15,686 patients were included in this analysis. Of them, 810 (5.2%) subjects had a COPD diagnosis. They were more often elderly and with a more pronounced cardiovascular risk profile. No preminent procedural dis‑ similarities were noticed except for a lower proportion of dual antiplatelet therapy at discharge among COPD patients (98.9% vs. 98.1%, P=0.038). With regards to short-term fatal outcomes, both in-hospital and 30-days mortality occurred more frequently among COPD patients, similarly in pre-COVID-19 and COVID-19 era. However, after adjust‑ ment for main baseline differences, COPD did not result as independent predictor for in-hospital death (adjusted OR [95% CI]=0.913[0.658–1.266], P=0.585) nor for 30-days mortality (adjusted OR [95% CI]=0.850 [0.620–1.164], P=0.310). No significant differences were detected in terms of SARS-CoV-2 positivity between the two groups. Conclusion: This is one of the largest studies investigating characteristics and outcome of COPD patients with STEMI undergoing primary angioplasty, especially during COVID pandemic. COPD was associated with significantly higher rates of in-hospital and 30-days mortality. However, this association disappeared after adjustment for baseline charac‑ teristics. Furthermore, COPD did not significantly affect SARS-CoV-2 positivity.
Authors: De Luca, Giuseppe, Nardin, Matteo, Algowhary, Magdy, Uguz, Berat, Oliveira, Dinaldo C., Ganyukov, Vladimir, Zimbakov, Zan, Čerček, Miha, Okkels Jensen, Lisette, Loh, Poay Huan
Institutions: University of Sassari, Azienda Ospedaliero Universitaria di Sassari, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, Assiut University Hospitals, Assiut University, Bursa City Hospital, Universidade Federal de Pernambuco, Research Institute of Complex Problems of Cardiovascular Disease Russian Academy of Medical Sciences, Ss. Cyril and Methodius University in Skopje, Ljubljana University Medical Centre, Odense University Hospital, National University Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Sveučilište u Zagrebu, Queen Mary University of London, Universidad CES, Institut National de la Santé et de la Recherche Médicale, Radboud Universiteit, Universiteit Maastricht, Università degli Studi di Padova, Universitair Medisch Centrum Utrecht, Maastricht Universitair Medisch Centrum, Università degli Studi di Sassari, Uniwersytet Łódzki, National Taiwan University Hospital, Eskişehir Osmangazi Üniversitesi, Radboud Universitair Medisch Centrum, Universitas Indonesia, National Taiwan University, Universidade Federal de Pernambuco, Universidade de Pernambuco, Assiut University, Masarykova Univerzita
OpenAlex ID: W7094078079
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