The relationship between chronic obstructive pulmonary disease and transcatheter aortic valve implantation—A systematic review and meta-analysis

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Abstract

Objective:

The present study was performed to investigate the relationship between chronic obstructive pulmonary disease (COPD) and transcatheter aortic valve implantation (TAVI). Background: Controversies regarding the relationship between COPD and TAVI have intensified. Methods: A literature review of the PubMed online database was performed, and articles published between January 1, 2002 and March 20, 2015 were analyzed. Random-effect and fixed-effect models were used, depending on the between-study heterogeneity. Results: A total of 28 studies, involving 51,530 patients, were identified in our review. The burden of COPD ranged from 12.5% to 43.4%, and COPD negatively impacted both short-term and long-term all-cause survival (30 days: odds ratio [OR], 1.43, 95% CI, 1.14–1.79; >2 years: hazard ratio [HR], 1.34, 95% CI, 1.12–1.61). COPD was also associated with increased short-term and mid-term cardiac-cause mortality (30 days: OR, 1.29, 95% CI, 1.02–1.64; 1 year: HR: 1.09, 1.02–1.17). Moreover, COPD (OR, 1.97, 95% CI, 1.29–3.0) predicted post-TAVI acute kidney disease. Importantly, chronic kidney disease (CKD) (HR, 1.2, 95% CI, 1.1–1.32) and the distance of the 6 minute walk test (6MWT) (HR, 1.16, 1.06–1.27) predicted TAVI futility in patients with COPD. Conclusion: COPD is common among patients undergoing TAVI, and COPD impacts both short- and long-term survival. COPD patients, who had a lower BMI, shorter distance of 6MWT and CKD, were at higher risk for TAVI futility. © 2016 Wiley Periodicals, Inc.

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