Among patients with COPD who survived hospitalization for AMI, more severe airflow obstruction was associated with substantially higher five-year all-cause mortality, supporting the potential role of spirometry-based risk stratification.
Five-year all-cause mortality after AMI increased progressively with greater airflow obstruction severity among COPD patients.
In multivariable analysis, more severe airflow obstruction was independently associated with substantially higher mortality risk compared to mild obstruction.
Only a small fraction of AMI patients with a COPD diagnosis had available spirometry data, limiting the analytical cohort.
COPD and AMI frequently coexist and share biological pathways and risk factors, yet the prognostic value of objective pulmonary function after AMI had not been well characterized prior to this study.
The authors conclude that spirometry-based risk stratification and integrated cardiopulmonary follow-up may be warranted after AMI in COPD patients.
This research suggests that among people who have both chronic obstructive pulmonary disease (COPD) and suffer a heart attack (acute myocardial infarction, or AMI), the severity of their lung disease—measured by a breathing test called spirometry—is strongly linked to how likely they are to die over the next five years. Specifically, patients with the most severe airflow obstruction (classified as 'Very Severe' by standard GOLD criteria) had a mortality rate of nearly 71% over five years, compared to only 19% in those with mild obstruction. Even after accounting for other factors, patients with very severe lung obstruction were about five times more likely to die than those with mild obstruction. The study drew from a large group of over 1,500 heart attack patients who also had a COPD diagnosis at a single hospital between 2002 and 2017, but only about 1 in 10 of those patients had an available spirometry test on record—meaning the findings come from a selected subset and may not apply to all COPD patients who experience a heart attack. This limitation means the results should be interpreted with some caution, though the trend across severity levels was statistically clear. This research suggests that routinely performing spirometry—a simple, non-invasive breathing test—in COPD patients who have had a heart attack could help identify those at highest risk of dying, potentially allowing for more intensive monitoring and coordinated care between heart and lung specialists. The findings highlight a gap in current practice, where lung function is often not formally assessed or used for risk prediction in cardiac patients with COPD.
Shashar S, Cohen T, Boehm Cohen L, Shmueli H, Shiyovich A, Gilutz H, et al.. (2026). COPD Severity and Five-Year Mortality After Acute Myocardial Infarction in Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study.. Medical sciences (Basel, Switzerland). https://doi.org/10.3390/medsci14040486