{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:57Z","timestamp":1787018097991,"version":"build-2736575974"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Acute myocardial infarction is a major cause of hospitalization and death in patients with chronic obstructive pulmonary disease (\n                      <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>\n                      ); however, temporal trends in the management and clinical outcomes of these patients remain unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We conducted an observational study by using a representative sample of 1\u00a0million beneficiaries from the Taiwan National Health Insurance Research Database. Comorbidities, in\u2010hospital treatment, and outcomes were compared for patients with acute myocardial infarction with and without\n                      <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>\n                      between 2004 and 2013. Temporal trends in treatment and outcomes were analyzed. We included 6770 patients admitted to hospitals with acute myocardial infarction diagnoses, of whom 1921 (28.3%) had\n                      <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>\n                      . Fewer patients with\n                      <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>\n                      received \u03b2\u2010blockers (adjusted odds ratio 0.66, 95% CI 0.59\u20130.74), angiotensin\u2010converting enzyme inhibitors\/angiotensin\n                      <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>\n                      receptor blockers (adjusted odds ratio 0.83, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.73\u20130.93), statins, anticoagulants, dual antiplatelets, and coronary interventions. These patients had higher mortality (in hospital: adjusted hazard ratio 1.25 [95% CI 1.11\u20131.41]; 1 year: adjusted hazard ratio 1.20 [95% CI 1.09\u20131.32]) and respiratory failure risk during admission. Temporal trends showed little improvement in mortality in patients with\n                      <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>\n                      over 10\u00a0years. Multivariable logistic regression indicated that dual antiplatelets, \u03b2\u2010blockers, angiotensin\u2010converting enzyme inhibitors\/angiotensin\n                      <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>\n                      receptor blockers, statins, coronary angiography, and coronary artery bypass grafting surgery were significantly correlated with improved mortality in patients with COPD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In Taiwan, a lower proportion of patients with\n                      <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>\n                      received evidence\u2010based therapies for acute myocardial infarction than did patients without\n                      <jats:styled-content style=\"fixed-case\">COPD<\/jats:styled-content>\n                      , and their clinical outcomes were inferior. Limited improvement in mortality was observed over the preceding 10\u00a0years and is attributable to the underuse of evidence\u2010based treatments.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.116.004525","type":"journal-article","created":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T20:50:19Z","timestamp":1489611019000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Temporal Trends in Treatment and Outcomes of Acute Myocardial Infarction in Patients With Chronic Obstructive Pulmonary Disease: A Nationwide Population\u2010Based Observational Study"],"prefix":"10.1161","volume":"6","author":[{"given":"Tse\u2010Hsuan","family":"Su","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Chang Gung Memorial Hospital Linkou Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang\u2010Hung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Chang Gung Memorial Hospital Linkou Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010Chun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Public Health China Medical University Taichung Taiwan"},{"name":"Department of Medical Research China Medical University Hospital Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Ling","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Chang Gung Memorial Hospital Linkou Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07492-2"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S31236"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/2049-6958-8-58"},{"key":"e_1_3_1_5_2","first-page":"2459","article-title":"COPD in Taiwan: a national epidemiology survey","volume":"10","author":"Cheng SL","year":"2015","unstructured":"Cheng SL, Chan MC, Wang CC, Lin CH, Wang HC, Hsu JY, Hang LW, Chang CJ, Perng DW, Yu CJ. 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