Abstract 13145: Impact of Chronic Obstructive Pulmonary Disease and Smoking on Clinical Outcomes After Percutaneous Coronary Intervention

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the third cause of death worldwide and often coexists with cardiovascular disease. Smoking is a common risk factor which promotes both respiratory and atherosclerotic disease. Whether COPD patients are at higher risk for cardiovascular events irrespective of smoking habit is poorly understood. Hypothesis: To investigate the additive prognostic impact of COPD and smoking in a cohort of patients undergoing percutaneous coronary intervention (PCI). Methods: Consecutive patients undergoing PCI at Mount Sinai Hospital, NY, between 2012-2019 were included and stratified by the presence of COPD at baseline. Active smoking was defined as the presence of smoking anytime during the year prior to admission. There were no formal exclusion criteria, except for the absence of information on COPD and smoking status. The primary endpoint was the composite of all-cause death or myocardial infarction at one year of follow-up. Results: Of the 16,313 patients included in the analysis, 1,295 (7.94%) had COPD. Patients with COPD were older, more often Caucasian, and had higher burden of comorbidities including hypertension, cancer, chronic kidney disease, heart failure. Active smoking was more common in COPD patients compared to those without COPD (27.3% vs. 15.4%, p<0.001). The primary endpoint occurred more frequently in COPD patients (4.6% vs. 2.0%; HR 2.3, 95% CI 1.7-3.1; p<0.001), with a graded risk by smoking status ( FigureA ). Findings were consistent after multivariable adjustment ( FigureB ). Conclusion: In a large and contemporary cohort of patients undergoing PCI, those with COPD were at higher risk of death or myocardial infarction compared to those without COPD, and this risk was further enhanced among COPD patients who smoked.