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

Liao, Yanbiao; He, Ze-Xia; Zhang, Zhengang; Wei, Xin; Zuo, Zhi‐Liang; Li, Yijian; Xiong, Tingting; Yang, Xu; Feng, Yuan; Chen, Mao

doi:10.1002/ccd.26443

Cited by 34 publications

(32 citation statements)

References 53 publications

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“…Currently, TAVR is a treatment modality for patients with severe aortic stenosis, especially those who are at prohibitive or high surgical risk . A number of comorbid conditions have been associated with increased morbidity and mortality after TAVR . However, there are contradicting data on the impact of DM on post‐TAVR outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Diabetes mellitus is associated with increased acute kidney injury and 1‐year mortality after transcatheter aortic valve replacement: A meta‐analysis

Mina

Gill

Soliman

et al. 2017

Clinical Cardiology

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Background Diabetes mellitus (DM) is associated with adverse outcomes after surgical aortic valve replacement. However, there are conflicting data on the impact of DM on outcomes of transcatheter aortic valve replacement (TAVR). Hypothesis DM is associated with poor outcomes after different cardiac procedures. Therefore, DM can also be associated with poor outcomes after TAVR. Methods We searched PubMed and Cochrane Central Register of Controlled Trials for studies that evaluated outcomes after TAVR and stratified at least 1 of the studied endpoints by DM status. The primary endpoint was all‐cause mortality at 1 year. Secondary endpoints were early (up to 30 days) mortality, acute kidney injury (AKI), cerebrovascular accident (CVA), major bleeding, and major vascular complications. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random effects models. Results We included 64 studies with a total of 38 686 patients. DM was associated with significantly higher 1‐year mortality (OR: 1.14, 95% CI: 1.04‐1.26, P = 0.008) and periprocedural AKI (OR: 1.28, 95% CI: 1.08‐1.52, P = 0.004). On the other hand, there were no significant differences between diabetics and nondiabetics in early mortality, CVAs, major bleeding, or major vascular complications. Conclusions DM is associated with increased 1‐year mortality and periprocedural AKI in patients undergoing TAVR. The results of this study suggest that DM is a predictor of adverse outcomes in patients undergoing TAVR.

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Section: Discussionmentioning

confidence: 99%

“…16,17 A number of comorbid conditions have been associated with increased morbidity and mortality after TAVR. [18][19][20][21] However, there are contradicting data on the impact of DM on post-TAVR outcomes.…”

Section: Major Vascular Complicationsmentioning

confidence: 99%

Diabetes mellitus is associated with increased acute kidney injury and 1‐year mortality after transcatheter aortic valve replacement: A meta‐analysis

Mina

Gill

Soliman

et al. 2017

Clinical Cardiology

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“…More recently Poulsen et al, have evidenced that, in patients with severe AS treated with TAVI, the presence of COPD affects neither overall survival nor survival from cardiac death. However, other authors have demonstrated a significantly higher mortality among TAVI patients with COPD compared with those without this condition . Despite this, Dziewierz et al did not found differences in mortality between patients with and without COPD after adjustment for most of the frailty indices.…”

Section: Discussionmentioning

confidence: 89%

“…Patients with AS are usually older and often present with multiple comorbidities. These include chronic obstructive pulmonary disease (COPD), which is present in up to 20% of patients presenting for SAVR and in up 43% of those presenting for TAVI . The higher prevalence of COPD in patients undergoing TAVI vs. SAVR could be explained by the fact that this condition is a major limiting factor in patient selection for surgical intervention …”

Section: Introductionmentioning

confidence: 99%

Impact of COPD on outcomes in hospitalized patients treated with transcatheter aortic valve implantation or surgical aortic valve replacement in Spain

Miguel‐Díez

López‐de‐Andrés

Hernández-Barrera

et al. 2019

Cathet Cardio Intervent

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Objectives: To describe the use of transcatheter aortic valve implantation (TAVI) and conventional surgery (SAVR) among hospitalized patients with and without COPD, to compare the in-hospital mortality (IHM), length of hospital stay (LOHS) and cost between patients with COPD undergoing TAVI and SAVR and to identify factors associated to IHM among these patients.Background: TAVI would be expected to be less invasive and safer than SAVR among COPD patients. Methods:We analyzed patients whose medical procedures included TAVI and SAVR included in the Spanish National Hospital Discharge Database, 2014-2015. We stratified analysis by COPD status. Propensity score matching (1:2) was performed to assess the outcomes of TAVI vs. SAVR among COPD patients.Results: We identified 2,141 and 16,013 patients who underwent TAVI (27.60% with COPD) and SAVR (19.31% with COPD) respectively. For TAVI, we found no differences in IHM according to COPD status. Patients undergoing SAVR and suffering COPD had higher IHM than patients without COPD (adj.OR 1.32; 95%CI 1.10-1.58). After propensity score matching, IHM (8.35% vs. 5.83%, p = .040) and LOHS (18.62 days vs. 13.62; p < .001) were higher in COPD patients who underwent SAVR than those who underwent TAVI.Conclusions: COPD patients undergoing TAVI did not have a worse prognosis compared to non-COPD patients during hospitalization. However, for SAVR, patients with COPD had significantly higher mortality than patients without this condition. COPD patients who underwent SAVR had higher IHM and LOHS than propensity score matched TAVI patients. K E Y W O R D S aortic valve disease, epidemiology, transcatheter valve implantation

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“…Additionally, chronic lung disease and atrial fibrillation (AF)/flutter were more frequent in patients undergoing TAVI with than without RV dilatation in a study by Ito et al , which are addressed in the Society of Thoracic Surgeons Predicted Risk of Mortality as risk factors of operative mortality. In a meta‐analysis by Liao et al of 28 studies enrolling 51,530 patients undergoing TAVI, prevalence of chronic obstructive pulmonary disease ranged from 12.5 to 43.4%, and it was associated with increased 30‐day and > 2‐year all‐cause mortality and 30‐day and 1‐year cardiac mortality after TAVI.…”

Section: Discussionmentioning

confidence: 99%

Impact of concurrent tricuspid regurgitation on mortality after transcatheter aortic‐valve implantation

Takagi

Hari

Kawai

et al. 2018

Cathet Cardio Intervent

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Objectives To determine whether concomitant tricuspid regurgitation (TR) is associated with increased mortality in patients with severe aortic stenosis (AS) undergoing transcatheter aortic‐valve implantation (TAVI), we performed a meta‐analysis of currently available studies. Methods MEDLINE and EMBASE were searched through May 2018. We included comparative or cohort studies enrolling patients with AS undergoing TAVI and reporting early (in‐hospital or 30‐day) and late (including early) all‐cause mortality in patients stratified by baseline TR grade. An odds ratio (OR) of early mortality and a hazard ratio (HR) of late mortality with its 95% CI for significant versus non‐significant (typically, ≥moderate versus

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

Abstract: 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.

Cited by 34 publications

References 53 publications

Diabetes mellitus is associated with increased acute kidney injury and 1‐year mortality after transcatheter aortic valve replacement: A meta‐analysis

Diabetes mellitus is associated with increased acute kidney injury and 1‐year mortality after transcatheter aortic valve replacement: A meta‐analysis

Impact of COPD on outcomes in hospitalized patients treated with transcatheter aortic valve implantation or surgical aortic valve replacement in Spain

Impact of concurrent tricuspid regurgitation on mortality after transcatheter aortic‐valve implantation

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