Differences in recognition and treatment of STEMIs between patients with COPD and non-COPD patients
| Inhospital treatment and diagnosis | COPD N (%) | Non-COPD N (%) | Unadjusted OR (95% CI) | Minimally adjusted OR (95% CI)* | Adjusted OR (95% CI)† |
|---|---|---|---|---|---|
| Initial diagnosis other than definite STEMI (for final diagnosis is STEMI) | 3080 (23.9) | 24 752 (19.9) | 1.26 (1.21 to 1.32) | 1.28 (1.23 to 1.34) | 1.24 (1.19 to 1.30) |
| Initial diagnosis other than ACS | 1186 (9.2) | 7398 (6.0) | 1.59 (1.50 to 1.71) | 1.68 (1.64 to 1.73) | 1.52 (1.42 to 1.62) |
| Primary PCI | 4108 (31.8) | 44 177 (35.6) | 0.84 (0.81 to 1.87) | 0.69 (0.67 to 0.71) | 0.87 (0.83 to 0.92) |
| Thrombolysis | 5449 (42.6) | 52 414 (42.7) | 0.99 (0.96 to 1.03) | 1.00 (0.96 to 1.03) | 0.96 (0.91 to 1.10) |
| Time to reperfusion | COPD Minutes (median IQR) | Non-COPD Minutes (median IQR) | Unadjusted exponentiated regression coefficient (95% CI) | Minimally adjusted exponentiated regression coefficient (95% CI)* | Adjusted exponentiated regression coefficient (95% CI)† |
|---|---|---|---|---|---|
| Time to reperfusion from admission (overall) | 37.1 (21.8–67.7) | 35.0 (21.8–63.4) | 1.07 (1.04 to 1.09) | 1.05 (1.03 to 1.07) | 1.04 (1.02 to 1.07) |
| Time to reperfusion from admission (initial diagnosis other than STEMI) | 152.9 (74.3–705.6) | 109.2 (50.2–260.0) | 1.44 (1.24 to 1.67) | 1.35 (1.16 to 1.58) | 1.47 (1.15 to 1.88) |
| Time to reperfusion from admission (initial diagnosis STEMI) | 35.0 (21.8–63.4) | 35.0 (21.8–61.2) | 1.04 (1.01 to 1.06) | 1.03 (1.01 to 1.05) | 1.03 (1.00 to 1.05) |
| Discharge treatment | COPD n (%) | Non-COPD n (%) | Unadjusted OR (95% CI) | Minimally adjusted OR* (95% CI) | Adjusted OR (95% CI)† |
|---|---|---|---|---|---|
| Discharge on β blockers | 5776 (44.7) | 94 784 (76.4) | 0.25 (0.24 to 0.26) | 0.25 (0.24 to 0.26) | 0.26 (0.25 to 0.27) |
| Discharge on ACE inhibitor or angiotensin receptor blocker | 9579 (74.2) | 96 508 (77.8) | 0.83 (0.79 to 0.86) | 0.87 (0.83 to 0.91) | 0.89 (0.85 to 0.93) |
| Discharge on aspirin | 10 344 (80.1) | 102 925 (82.9) | 0.83 (0.79 to 0.87) | 0.87 (0.83 to 0.92) | 0.90 (0.85 to 0.94) |
| Discharge on statin | 10 373 (80.4) | 102 785 (82.8) | 0.85 (0.81 to 0.89) | 0.88 (0.84 to 0.93) | 0.91 (0.86 to 0.95) |
| Discharge on thienopyridine | 7799 (60.4) | 77 543 (62.5) | 0.91 (0.88 to 0.95) | 0.96 (0.92 to 1.01) | 0.98 (0.94 to 1.03) |
*Adjusted for age, sex smoking status and calendar year.
†Adjusted for age, sex, smoking status, calendar year, drugs on admission and comorbidities.
ACS, acute coronary syndromes; COPD, chronic obstructive pulmonary disease; STEMI, ST-elevation myocardial infarction.