The study published by Zhang et al. The study was conducted among a group of 2, patients undergoing PCI. Among them, 9. Since the cardiac mortality rate was zero in both groups, no differences were found between them. The important fact is that the authors did not mention any information about the distribution of CAD clinical presentation before PCI or the type of coronary atherosclerosis.
The increased rate of periprocedural MIs in patients with COPD as compared to the non-COPD group could be explained by more complex and disseminated coronary atherosclerosis as well as the difference in clinical presentation resulting from it. Whereas the increased rate of no-reflows and CAs could undoubtedly be related to the prothrombotic state attributed to COPD patients and the impeded return of blood flow through the vessel in STEMI patients related to it [ 15 , 16 ]. Moreover, the relationship between no-reflows and the COPD as a prothrombotic state have been more widely discussed in two previously published manuscripts [ 17 , 18 ].
Furthermore, according to our knowledge, this is the first study verifying that among several confirmed predictors, smoking and COPD are independent risk factors of a higher incidence of no-reflows in patients undergoing PCI. In contrast to our results, research conducted by other authors revealed that patients with COPD were more likely to experience major entry site complications than patients without COPD [ 16 , 19 ].
The leading entry site periprocedural complication was higher rate of bleeding that required transfusion in COPD patients. The study published by Enriquez et al. It was attributed mainly to age, gender and therapy implementing warfarin [ 16 , 19 ]. However, most studies maintain the thesis that the etiology of increased risk of periprocedural entry side bleeding is multifactorial [ 5 ].
Similarly, Mukherjee et al. They noticed that among participants, Based on this, it could be concluded that patients with COPD and smokers present restrained allergic reactions. According to our knowledge, the present study is the first study which demonstrates that COPD and smoking are independent predictors of decreased periprocedural allergic reaction rate in the overall group of patients undergoing PCIs.
Similar concerns could be applied to periprocedural complications and their definitions usually remain in the hands of operators. This could bring some false positive or false negative diagnosis of COPD and bias related to this issue. However this is a typical problem for the national registry. From the other side it presents the real life and the real frequency of COPD diagnosis confirmed in spirometry is close to the presented in the study.
Patients with exacerbated COPD at admission could be treated in some cases with systemic glucocorticoids, which might modify the extent and frequency of procedural-related allergic reactions. Cardiac arrests, myocardial infarctions and no-reflows may be found among the periprocedural complications with the largest contribution.
What are the possible complications of percutaneous coronary intervention (PCI )?. Updated: Oct 11, Author: George A Stouffer, III, MD; Chief Editor. Complications seen during percutaneous coronary intervention (PCI) include those related to cardiac catheterization and diagnostic coronary.
COPD was not an independent predictor of periprocedural complications in the overall group of patients undergoing PCI, while COPD and smoking were found to be independent predictors of decreased allergic reaction periprocedural rate and increased rate of periprocedural no-reflows. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field.
Abstract Background The relationship between chronic obstructive pulmonary disease COPD and periprocedural complications of percutaneous coronary interventions PCIs is influenced by several factors. Funding: The authors received no specific funding for this work. Introduction The prevalence of chronic obstructive pulmonary disease COPD in the general population is estimated at 7. Materials and methods Study population, design and definitions We analyzed prospectively collected national data from all patients who underwent PCIs in Poland between January and December Statistical analysis All continuous variables were evaluated with the Kolmogorov-Smirnov test for distribution.
Download: PPT. Fig 1. Table 1. Periprocedural complications and distribution of coronary artery atherosclerosis The COPD group consisted of 3, patients with single-vessel disease SVD Table 2. Gender and periprocedural complications There were 4, males Table 3.
Predictors of all periprocedural complications, allergic reactions and no-reflows Among several independent predictors of all periprocedural complication rates estimated by multivariate analysis in the overall group of patients undergoing PCIs, COPD was not confirmed to be an independent predictor Fig 2. Fig 2. Predictors of all periprocedural complications assessed by multivariate analysis in the overall group of patients undergoing PCI. Fig 3. Predictors of allergic reactions during PCI assessed by multivariate analysis in the overall group of patients undergoing PCI.
Fig 4. Predictors of no-reflow complications during PCI assessed by multivariate analysis in the overall group of patients undergoing PCI. References 1. Raherison C, Girodet PO. Epidemiology of COPD. Eur Respir Rev. Prevalence and prognosis of chronic obstructive pulmonary disease among Middle Eastern patients with acute coronary syndrome. Clin Cardiol.
Chronic obstructive pulmonary disease—an independent risk factor for long-term cardiac and cardiovascular mortality in patients with ischemic heart disease. Int J Cardiol. Applegate R. J, Sacrinty M. T, Kutcher M. Trends in vascular complications after diagnostic cardiac catheterization and percutaneous coronary intervention via the femoral artery, to Int Heart J. Significantly improved vascular complications among women undergoing percutaneous coronary intervention: a report from the Northern New England Percutaneous Coronary Intervention Registry.
T, Kutcher M. Abstract Background The relationship between chronic obstructive pulmonary disease COPD and periprocedural complications of percutaneous coronary interventions PCIs is influenced by several factors. Save my selection. Manuscript received July 8, ; provisional acceptance given October 18, ; manuscript accepted October 21, Not only major but also minor bleedings were once shown to increase mortality.
Circ Cardiovasc Interv. Catheter Cardiovasc Interv Reduced periprocedural mortality and bleeding rates of radial approach in ST-segment elevation myocardial infarction. Time trends in coronary revascularization procedures among people with COPD: analysis of the Spanish national hospital discharge data — Management and mortality in patients with non-ST-segment elevation vs. ST-segment elevation myocardial infarction. Kardiol Pol. Impact of chronic obstructive pulmonary disease on patient with acute myocardial infarction undergoing primary percutaneous coronary intervention.
Biomed J. Biomed Res Int. Hypercoagulability state in patients with chronic obstructive pulmonary disease. Chronic Obstructive Bronchitis and Haemostasis Group. Thromb Haemost. Development and validation of a bleeding risk model for patients undergoing elective percutaneous coronary intervention. Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions.
Pol Arch Intern Med. Chronic obstructive pulmonary disease affects angiographic presentation and outcomes. If you have diabetes and multiple blockages, your doctor may suggest coronary artery bypass surgery. The decision of angioplasty versus bypass surgery will depend on the extent of your heart disease and overall medical condition. Although angioplasty is a less invasive way to open clogged arteries than bypass surgery is, the procedure still carries some risks.
Blood clots can form within stents even after the procedure. These clots can close the artery, causing a heart attack. It's important to take aspirin, clopidogrel Plavix , prasugrel Effient or another medication that helps reduce the risk of blood clots exactly as prescribed to decrease the chance of clots forming in your stent. Talk to your doctor about how long you'll need to take these medications.
Never discontinue these medications without discussing it with your doctor. Before a scheduled angioplasty, your doctor will review your medical history and do a physical exam.