TCT-312 Increased Cardiac Death and Stent Thrombosis in Chronic Obstructive Pulmonary Disease Patients Undergoing Percutaneous Coronary Intervention. An analysis of the BASKET-PROVE I and II trials

Background COPD is associated with long-term all-cause death following PCI with bare-metal stents (BMS). Regarding other outcomes previous studies have shown conflicting results and the impact of drug-eluting stent (DES) in this population is not well known. We sought to evaluate the impact of chronic obstructive pulmonary disease (COPD) on percutaneous coronary intervention (PCI) outcomes, and the interaction with stent type. Methods We analyzed 4605 patients that underwent PCI with BMS (33.1%) or DES (66.9%) from the BASKET-PROVE trials I and II. Results COPD patients (n=283, 6.1%), were older and had more frequently a smoking or cardiovascular event history. At 2-year follow-up, cumulative event rates for patients with versus without COPD were the following: major adverse cardiac events [MACE: composite of cardiac death, non-fatal myocardial infarction (MI) and target vessel revascularization]: 15.2 vs. 8.1% (p<0.001); all-cause death: 11.7 vs. 2.4%, (p<0.001); cardiac death: 5.7 vs. 1.2%, (p<0.001); MI: 3.5 vs. 1.9% (p=0.045); definite/probable/possible stent thrombosis: 2.5 vs. 0.9% (p=0.01); and major bleeding: 4.2 vs. 2.1% (p=0.014). After adjusting for confounders including smoking status, COPD remained an independent predictor for MACE (HR 1.80, 95%CI 1.31-2.49), all-cause death (HR 3.62, 95%CI 2.41-5.45), cardiac death (HR 3.12, 95%CI 1.74-5.60) and stent thrombosis (HR 2.39, 95% CI 1.03-5.54). We did not find evidence of an interaction between COPD and DES implantation (P for interaction = 0.29).