Chronic obstructive pulmonary disease and miocardial revascularisation outcomes: relationship with self-reported quality of life

Abstract

Aim. To assess the impact of chronic obstructive pulmonary disease (COPD) on the outcomes of myocardial revascularisation and the self-reported quality of life (QoL) during long-term follow-up. Methods. This prospective cohort study included 454 consecutive patients who underwent scheduled myocardial revascularisation. The follow-up continued for 3 years after the surgery. All patients underwent pulmonary functional tests before the surgery. The diagnosis of COPD was verified according to the Global Initiative for Obstructive Lung Disease criteria. QoL assessment was performed before and 3 years after the surgery using the 36-Item Short-Form Health Survey (SF-36). Results. In the study group, the diagnosis of COPD was verified in 14.5% of cases. The mortality rate was 5%, and was significantly higher in patients with COPD. The baseline QoL level was reduced in all patients, regardless of the presence of COPD, with an average of 50 points both in the physical and mental health scores of the SF-36 questionnaire. COPD had a significant negative impact on the QoL physical health score after myocardial revascularisation (odds ratio (OR) 0.95 (0.91 - 0.99), p = 0.043). The forced expiratory volume in the first second (OR 1.02 (1.00 - 1.07), p = 0.048) and new-onset atrial fibrillation in the early postoperative period (OR 0.54 (0.33 - 0.88), p = 0,036) were predictors of lack of QoL improvement. COPD did not correlate with the changes in the psychoemotional component of QoL. Conclusion. COPD has an independent negative impact on the clinical outcomes of myocardial revascularisation, including survival and health-related QoL (physical health score). Thereby, preoperative assessment of the respiratory function is important in these patients.