AUTHOR=Zheng Yitian , Qi Yu , Seery Samuel , Wang Wenyao , Zhao Wei , Shen Tao , Zhou Lequn , Yang Jie , Li Chen , Wang Xuliang , Gao Jun , Meng Xiangbin , Dong Erdan , Tang Yi-Da 

TITLE=Long-Term Outcomes for Chinese COPD Patients After PCI: A Propensity Score Matched, Double-Cohort Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.827635

DOI=10.3389/fcvm.2022.827635

ISSN=2297-055X

ABSTRACT=Objectives
To analyze long-term outcomes of Chinese coronary artery disease (CAD) patients with (and without) Chronic Obstructive Pulmonary Disease (COPD) after Percutaneous Coronary Intervention (PCI).
Background
COPD is a chronic condition which often develops in conjunction with CAD. PCI is a core therapy for CAD, although we still need to understand CAD-COPD outcomes and to identify factors which influence prognoses, across ethnicities. 
Methods
This double-cohort study involved 12,343 Chinese CAD patients who received PCI. Baseline characteristics were collected in two independent, specialty centers. Propensity-score matching was performed to control for confounding factors, using a nearest neighbor matching method within a 0.02 caliper and on a propensity score scale of 0.1 for each center. Comorbid CAD-COPD cases were compared to non-COPD patients in terms of major adverse cardiac events (MACE).
Results
Those with COPD were generally older than those without (65.4±9.2 vs 58.2±10.3, p<0.001). There were no significant differences of endpoints between COPD and non-COPD groups after PCI (All p>0.05); however, the incidence of MACEs increased after 450 days. Further subgroup analysis suggests that COPD is approximately four times more prevalent among those over 75 years old (HR, 3.818; 95%CI, 1.10-13.29; p=0.027) and those younger than 55 years (HR = 4.254; 95% CI, 1.55-11.72; p=0.003).
Conclusions
Having COPD does not appear to have a significant impact on CAD outcomes two years after PCI, and beyond. However, an increased number of MACEs was observed after 450 days, which suggests there may be a double-stage effect of COPD on PCI prognosis. There is a need for focused comorbidity management, specifically for those younger than 55 and older than 75 years of age.