Impact of chronic obstructive pulmonary disease on survival and symptoms of severe aortic valve stenosis

Poulsen, Mikael Kjær; Dahl, Jordi S.; Kjeldsen, Bo Juel; Nørregaard-Hansen, Knud; Pedersen, Knud Erik; Mickley, Hans; Nissen, Henrik

doi:10.3109/14017431.2015.1006671

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…A total of 1110 citations were identified, and 85 full‐length studies remained after carefully screening the title and abstract. A total of 28 studies, incorporating 51,530 patients, met our inclusion and exclusion criteria after reading the full text. Although there were two studies that had overlapping data, they reported on different clinical aspects that we wanted to address.…”

Section: Resultsmentioning

confidence: 99%

“…Since the effectiveness and safety of transcatheter aortic valve implantation (TAVI) has been proven, patients with COPD who are deemed inoperable or at high risk are now likely to be referred for TAVI . Nevertheless, the impact of COPD on prognosis after TAVI is debatable; some studies reported a detrimental effect of COPD , while other studies showed no effect . Therefore, the present systematic review and meta‐analysis aimed to investigate the relationship between COPD and TAVI.…”

Section: Introductionmentioning

confidence: 99%

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

Liao

Zhang

et al. 2016

Cathet Cardio Intervent

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Liao

Zhang

et al. 2016

Cathet Cardio Intervent

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“…Importantly, our findings stay in line with the previous studies reporting association between COPD and adverse outcomes after TAVI [ 13 – 15 , 21 , 22 ]. However, other studies presented contradictory results suggesting no influence of COPD on mortality after TAVI [ 16 , 17 ]. For instance, in multicenter Canadian experience, the strongest predictor of late mortality was COPD followed by chronic kidney disease, chronic atrial fibrillation, and frailty [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, in spite of an improvement in outcomes and quality of life (QoL) after TAVI [ 5 – 12 ], recently, some studies reported a detrimental effect of COPD on outcomes of patients with severe AS undergoing TAVI [ 13 – 15 ]. Nevertheless, the impact of COPD on TAVI results seems to be still unclear [ 16 , 17 ]. Also, data on the possible associations between COPD, frailty, QoL, and outcomes for patients undergoing TAVI are scarce.…”

Section: Introductionmentioning

confidence: 99%

Impact of chronic obstructive pulmonary disease and frailty on long-term outcomes and quality of life after transcatheter aortic valve implantation

et al. 2017

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BackgroundAssociation between chronic obstructive pulmonary disease (COPD) and long-term mortality as well as the quality of life (QoL) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) is still unclear.AimWe sought to evaluate the impact of COPD on mortality and QoL of patients with AS undergoing TAVI.MethodsA total of 148 consecutive patients who underwent TAVI were enrolled and stratified by history of COPD.ResultsOf 148 patients enrolled, 19 (12.8%) patients had a history of COPD. Patients with COPD were high-risk patients with higher prevalence of incomplete revascularization and frailty features. At follow-up of 15.8 months, all-cause mortality in patients with COPD was over four times higher than in patients without COPD [17.8% vs. 52.6%; p = 0.002—age/gender-adjusted OR (95% CI) 4.73 (1.69–13.24)]. On the other hand, in Cox regression model, the only independent predictors of all-cause death at long-term follow-up were: incomplete coronary revascularization [HR (95% CI) 5.45 (2.38–12.52); p = 0.001], estimated glomerular filtration rate [per 1 ml/min/1.73 m2 increase: 0.96 (0.94–0.98); p = 0.001], and previous stroke/transient ischemic attack [2.86 (1.17–7.00); p = 0.021]. Also, the difference in mortality between patients with and without COPD was not significant after adjustment for the most of frailty indices. Importantly, groups were comparable in terms of QoL at baseline and 12 months.ConclusionCOPD may pose an important factor affecting long-term outcomes of patients with severe AS undergoing TAVI. However, its effects might be partially related to coexisting comorbidities and frailty.

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“…Analysis of data from the German Transcatheter Aortic Valve Interventions–Registry, including 1,391 patients treated with TAVI at 27 hospitals, did not identify COPD as an independent predictor of mortality . 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 .…”

Section: Discussionmentioning

confidence: 97%

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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Impact of chronic obstructive pulmonary disease on survival and symptoms of severe aortic valve stenosis

Cited by 7 publications

References 19 publications

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

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

Impact of chronic obstructive pulmonary disease and frailty on long-term outcomes and quality of life after transcatheter aortic valve implantation

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

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