National trends in utilization and outcomes of percutaneous coronary intervention (PCI) among patients with and without COPD in Spain (2001-2011)

Background: COPD is associated with a high risk of death due to coronary artery disease (CAD). Patients with COPD suffering from CAD are frequently treated with revascularization procedures. Objective: We aim to compare trends in the use and outcomes of percutaneous coronary intervention (PCI) in patients with and without COPD in Spain (2001-2011). Methods: We identified all patients who had undergone PCI, using national hospital discharge data. Discharges were divided, according to a history of COPD, in: COPD and non COPD. Results: From 2001 to 2011, 434,108 PCIs were performed. The incidence of use of PCI increased over time in both groups, from 4.94 per 100,000 inhabitants in 2001 to 11.76 in 2011 in COPD, and from 87.74 to 177.56 in non COPD. The mean age increased significantly in both groups, from 68.07 (8.97) years in 2001 to 70.57 (9.92) years in 2011 in COPD patients and from 63.35 (11.2) years in 2001 to 65.43 (12.07) years in 2011 in non-COPD patients. Comorbidity increased significantly in both groups. The average LOS decreased significantly over time, from 9 (IQR 10) days in 2001 to 6 (IQR 6) days in COPD patients, and from 6 (IQR 9) days in 2001 to 5 (IQR 6) days in patients without COPD. IHM changed significantly over the entire study period among patients with COPD (from 2.65% in 2001 to 2.66% en 2011) and non COPD (from 1.92% in 2001 to 1.85% in 2011). Conclusions: The incidence of use of PCI procedures increased over time in COPD and non-COPD patients. Increasing age and comorbidity can be associated with a higher use of PCI procedures. LOS and IHM were higher in patients with COPD than in those without COPD.