COPD was associated with higher 10-year mortality following NSTEMI (HR 1.58; 95% CI 1.56-1.60), whereas asthma was associated with a lower risk (HR 0.97; 95% CI 0.95-0.98).
Cohort (n=499,318)
Yes
Does the presence of obstructive airways disease (COPD or asthma) worsen inpatient care quality and long-term mortality in adults with NSTEMI?
Patients with NSTEMI and comorbid COPD receive lower-quality inpatient care and fewer coronary interventions, which correlates with significantly higher long-term and cardiovascular mortality compared to those without airway disease.
Hazard Ratio: 1.58 (95% CI 1.56–1.6)
Acute myocardial infarction is a major cause of mortality in individuals with obstructive airway disease. The impact of inpatient care quality following non-ST elevation myocardial infarction (NSTEMI) on long-term mortality among those with chronic obstructive pulmonary disease (COPD) and asthma remains poorly understood. We analysed 499 318 adults with NSTEMI from the Myocardial Ischaemia National Audit Project registry between 2005 and 2019, linked with Hospital Episode Statistics for airway disease diagnosis and Office for National Statistics data for mortality outcomes. Inpatient care quality was measured using the opportunity-based quality-indicator (OBQI) score. Long-term outcomes were evaluated using multivariable Cox regression and Kaplan-Meier analyses. Individuals with COPD and asthma received lower quality of care (OBQI score: no airways disease: 83.5 vs COPD: 78.1, asthma: 80.8, P < .001). Percutaneous coronary intervention was less frequent in COPD patients (22%) than in those without airway disease (30%) or with asthma (31%), P < .001. COPD was associated with higher 10-year mortality (hazard ratio HR: 1.58, 95% CI 1.56-1.60), whereas those with asthma had lower risk (HR: 0.97, 95% CI 0.95-0.98). COPD was associated with increased adjusted cardiovascular mortality (sub-distribution HR: 1.89, 95% CI 1.84-1.95). Individuals with COPD received lower-quality inpatient care and fewer coronary interventions, which was associated with higher long-term mortality.
Cole et al. (Sat,) conducted a cohort in Non-ST elevation myocardial infarction (NSTEMI) (n=499,318). Chronic obstructive pulmonary disease (COPD) vs. No airway disease was evaluated on 10-year mortality (HR 1.58, 95% CI 1.56-1.60). COPD was associated with higher 10-year mortality following NSTEMI (HR 1.58; 95% CI 1.56-1.60), whereas asthma was associated with a lower risk (HR 0.97; 95% CI 0.95-0.98).