Key result
Prior PCI is linked to ~2-fold higher risk of 1-year adverse events in COPD-CAD.
Why the study?
Chronic coronary syndrome (CCS) and chronic obstructive pulmonary disease (COPD) frequently coexist, yet prognostic evidence for patients with both conditions remains limited.
Cohort (n=214)
In hospitalized patients with concomitant chronic coronary syndrome and COPD, smoking history, prior PCI, higher GOLD grade, and lower LVEF independently predict one-year cardiovascular and respiratory adverse outcomes, supporting integrated risk assessment.
Chronic coronary syndrome (CCS) and chronic obstructive pulmonary disease (COPD) frequently coexist, yet prognostic evidence for patients with both conditions remains limited. This retrospective cohort study evaluated factors associated with one-year adverse clinical outcomes and developed a clinical risk score in 214 hospitalized patients with CCS and concomitant COPD. Baseline clinical and laboratory data were collected, and patients were followed for one year. The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction (MI), rehospitalization for heart failure (HF), or rehospitalization for acute exacerbation of COPD (AECOPD) within one year. Independent prognostic factors were identified using Cox proportional hazards regression analysis. Model performance was evaluated through discrimination, calibration, decision curve analysis, and bootstrap internal validation. During follow-up, 53 patients (24.8%) experienced the composite endpoint, including 7 all-cause deaths (3.3%), 8 non-fatal MIs (3.7%), 17 HF-related rehospitalizations (7.9%), and 21 AECOPD-related rehospitalizations (9.8%). Smoking history (hazard ratio [HR] = 1.962, 95% confidence interval [CI]: 1.093-3.521, P = 0.024), previous percutaneous coronary intervention (PCI) (HR = 2.017, 95% CI: 1.157-3.517, P = 0.013), higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade (HR = 1.488, 95% CI: 1.092-2.028, P = 0.012), and lower left ventricular ejection fraction (LVEF) (HR = 0.933, 95% CI: 0.893-0.975, P = 0.002) were independently associated with the composite endpoint. The model demonstrated a concordance index (C-index) of 0.736 and a one-year area under the receiver operating characteristic curve (AUC) of 0.773. Event-free survival differed significantly among the low-, intermediate-, and high-risk groups (log-rank P < 0.001). These findings support integrated cardiovascular and respiratory risk assessment in patients with CCS and COPD. However, external validation is required before the risk score can be recommended for broader clinical application.
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Chao et al. (2026) conducted a cohort in Chronic coronary syndrome with concomitant chronic obstructive pulmonary disease (n=214). Clinical prognostic factors (smoking history, previous PCI, higher GOLD grade, lower LVEF) vs. Low-, intermediate-, and high-risk groups was evaluated on Composite of all-cause death, non-fatal myocardial infarction, rehospitalization for heart failure, or rehospitalization for acute exacerbation of COPD within one year (HR 2.017, 95% CI 1.157-3.517, p=0.013). Smoking, prior PCI (HR 2.02), higher GOLD grade, and lower LVEF independently predicted 1-year adverse events (24.8% overall; model AUC 0.773).
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