THE RELATIONSHIP BETWEEN CLINICAL AND FUNCTIONAL MANIFESTATIONS OF COPD AND RISK ASSESSMENT OF ADVERSE OUTCOME IN PERCUTANEOUS CORONARY INTERVENTION, FEATURES OF DRUG CORRECTION
Objective: to assess the relationship between clinical and functional manifestations of COPD and the risk of adverse outcome in percutaneous coronary intervention (PCI), to determine the features of drug correction. Materials and methods. The work is based on the data on the results of PCI in 711 patients with coronary artery disease: the 1st group consisted of 96 patients with COPD who underwent PCI; the IInd group included 615 patients without COPD after PCI. Results. The presence of concomitant COPD is associated with an increased risk of hospital mortality, development of cardiovascular complications (CVC) during follow-up period after PCI. Thus, patients with COPD were significantly older, the female sex prevailed, a more severe course was determined (Killip III, 14.2% versus 4.4%; the I and II groups respectively, p<0.05); predominantly three-vessel vascular lesion (56.6% versus 21.1%; p<0.05), a higher risk of hospital mortality (3.1% versus 0.02%; p<0.05). Arterial hypertension, Smoking, dyslipidemia, a decrease in glomerular filtration rate were more often diagnosed among the risk factors for CVC in patients with COPD (allp<0.05). In the regression analysis, the risk of adverse events was directly correlated with age (r=0.41), the Charlson comorbidity index (r=0.62), the risk group (r=0.55) and the frequency of COPD exacerbations (r=0.38). Conclusions: a comprehensive study of the results of PCI in patients with a combination of coronary artery disease and COPD revealed significant relationship of adverse outcomes of PCI (mortality, repeated revascularization and MI) with the main clinical characteristics of patients with COPD (CAT, mMRC, frequency of exacerbations of COPD) and comorbidity index. The presence of lesions of the cardiovascular and respiratory systems forms a vicious circle of mutual aggravation with the need for a comprehensive examination of the patient and the formation ofa high-risk group in order to optimize drug correction.