{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:31:53Z","timestamp":1786966313524,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Chronic obstructive pulmonary disease (COPD) and acute myocardial infarction (AMI) frequently coexist and share several biological pathways and risk factors. Although COPD is associated with worse outcomes after AMI, the prognostic value of objective pulmonary function has not been well characterized. The aim of this study was to evaluate the association between airflow-obstruction severity and five-year all-cause mortality after AMI among patients with COPD. Methods: This single-center retrospective cohort study was restricted to adult post-AMI patients (2002\u20132017) with a background diagnosis of COPD and documented spirometry; therefore, the final cohort represents a selected subgroup of the source COPD-AMI population. Airflow obstruction was categorized according to forced expiratory volume in one second (FEV1) as Mild, Moderate, Severe, or Very Severe (according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD)). The outcome was all-cause mortality during up to five years of follow-up. Results: Among 1594 patients hospitalized with AMI and a COPD diagnosis, 169 patients with available spirometry were included in this selected analytical cohort (mean age 66.76 \u00b1 9.86 years, 76.9% male). During follow-up, 65 patients died, corresponding to an overall five-year mortality rate of 38.5%. Mortality increased progressively across obstruction categories: 19.0%, 33.3%, 40.0%, and 70.8% in Mild, Moderate, Severe, and Very Severe, respectively (p for trend &lt;0.001). In multivariable analysis, adjusted hazard ratios for mortality were: 2.49 (95% CI 0.86\u20137.24), 3.38 (95% CI 1.09\u201310.46), and 5.23 (95% CI 1.62\u201316.89) for Moderate, Severe, and Very Severe, compared with Mild obstruction. Conclusions: Among patients with COPD who survived hospitalization for AMI, more severe airflow obstruction was associated with substantially higher five-year all-cause mortality. These findings support the potential role of spirometry-based risk stratification and highlight the need for integrated cardiopulmonary follow-up after AMI.<\/jats:p>","DOI":"10.3390\/medsci14040486","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:00:05Z","timestamp":1786964405000},"page":"486","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COPD Severity and Five-Year Mortality After Acute Myocardial Infarction in Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2386-8027","authenticated-orcid":false,"given":"Sagi","family":"Shashar","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Maccabi Healthcare Services, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahel","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel"},{"name":"Mother and Newborn Department, Barzilai Medical Center, Ashkelon, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liora","family":"Boehm Cohen","sequence":"additional","affiliation":[{"name":"Pulmonology Institute, Soroka University Medical Center, Beer Sheva, Israel"},{"name":"Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hezzy","family":"Shmueli","sequence":"additional","affiliation":[{"name":"Cardiology Division, Hillel Yaffe Medical Center, Hadera, Israel"},{"name":"Rappaport Faculty of Medicine, Technion University, Heifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7316-1882","authenticated-orcid":false,"given":"Arthur","family":"Shiyovich","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Heart and Vascular Institute, Mass General Brigham, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9543-7528","authenticated-orcid":false,"given":"Harel","family":"Gilutz","sequence":"additional","affiliation":[{"name":"Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0898-9776","authenticated-orcid":false,"given":"Ygal","family":"Plakht","sequence":"additional","affiliation":[{"name":"Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel"},{"name":"Department of Emergency Medicine, Soroka University Medical Center, Beer-Sheva 84101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1056\/NEJMra1606915","article-title":"Acute Myocardial Infarction","volume":"376","author":"Anderson","year":"2017","journal-title":"N. 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