Chronic obstructive pulmonary disease as a predictor of unfavourable prognosis in patients after myocardial revascularization

Abstract

Purpose. We aimed to analyze the results of the annual follow-up of the patients underwent coronary artery bypass grafting (CABG) depending on the presence of concomitant respiratory diseases. Materials and methods. In a year after CABG the prognosis of 646 patients, divided into three groups, was analyzed. A criterion for the formation of the groups was the presence of chronic pulmonary pathology and obstructive ventilatory type of disorders. The first group included 46 (7.1%) patients with coronary artery disease (CAD) and respiratory disease without the signs of obstructive disorder, the second group - 241 (37.3%) patients with CAD and chronic obstructive pulmonary disease (COPD) and the third - 359 (55.6%) patients with isolated CAD. Death, hospitalizations (both for cardiovascular events and respiratory diseases, non-fatal cardiovascular events, exacerbation and complications of COPD, as well as repeated revascularization procedures were evaluated as end points. Results. One year after CABG in patients with COPD the incidence of deaths, hospitalizations for acute cardiovascular events, as well as percutaneous coronary interventions was higher than in patients with isolated CAD. According to the analysis of variance, it was demonstrated that along with age, reduced myocardial systolic function and smoking, both COPD itself and the degree of bronchial obstruction are the potential risk factors for the development of fatal outcome. Conclusion. Comorbid COPD in patients with CAD is the predictor of unfavourable prognosis within a year after CABG.

Keywords

• coronary artery disease
• chronic obstructive pulmonary disease
• prognosis
• coronary artery bypass grafting