CHICAGO — Chronic obstructive pulmonary disease is a lethal comorbidity for myocardial infarction patients, and its deadly punch has grown over time, according to a community-based review of more than 3,000 patients.
In addition, chronic obstructive pulmonary disease (COPD) has become increasingly common among patients who have a myocardial infarction, affecting 16% of patients who had an a myocardial infarction during 2000–2005, compared with 8% during 1979–1985, Dr. Francesca Bursi and her associates reported in a poster at the annual meeting of the American College of Cardiology.
The deadly impact of coexisting COPD was so strong that it negated an overall temporal trend toward fewer patients dying following a myocardial infarction. The risk of death following an MI in patients with COPD, compared with those without COPD, rose from a 21% increased risk in 1979–1985 to a 2.6-fold increased risk during 2000–2005, reported Dr. Bursi, a cardiologist at the Mayo Clinic in Rochester, Minn.
Although the Mayo Clinic researchers who performed this analysis had no explanation for why the impact of COPD on post-MI mortality has increased, they said that their findings underscored the need to enhance therapy and follow-up for patients who face this double whammy.
The Mayo team reviewed data collected on 3,259 residents of Olmsted County, Minn., who had a myocardial infarction during 1979–2005 and were monitored through the Mayo Clinic's county-based community surveillance program. During an average follow-up of 4.8 years, 1,436 (44%) of these myocardial infarction patients died.
For the group overall, the confluence of MI and COPD boosted the risk of death by a statistically significant 38%, compared with patients without COPD, in an analysis that adjusted for several demographic and clinical differences including age, gender, smoking, hypertension, medications used, and revascularization treatment.