Major adverse cardiac events and mortality in chronic obstructive pulmonary disease following percutaneous coronary intervention: a systematic review and meta-analysis
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Published on: June 12, 2021
Pravesh Kumar Bundhun1, Chakshu Gupta2, Guang Ma Xu3
1Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530027, People's Republic of China.
Insights
Patients with Chronic Obstructive Pulmonary Disease (COPD) face higher risks of major adverse cardiac events and mortality after Percutaneous Coronary Intervention (PCI). This meta-analysis confirms COPD as a significant risk factor for adverse outcomes post-PCI.
Area of Science:
- Cardiology
- Pulmonology
- Interventional Cardiology
Background:
- Percutaneous Coronary Intervention (PCI) is a common procedure for coronary artery disease.
- Chronic Obstructive Pulmonary Disease (COPD) is a prevalent comorbidity that may impact cardiovascular outcomes.
- The impact of COPD on PCI outcomes requires systematic evaluation.
Purpose of the Study:
- To systematically compare Major Adverse Cardiac Events (MACEs) and mortality rates following PCI in patients with and without COPD.
- To determine if COPD is an independent risk factor for adverse outcomes after PCI.
Main Methods:
- A meta-analysis of English-language publications was conducted.
- Electronic databases (Cochrane library, EMBASE, Medline/PubMed) were searched for relevant studies.
- Statistical analysis involved calculating Odds Ratios (OR) and 95% Confidence Intervals (CI).
Main Results:
- The analysis included 72,969 patients (7518 with COPD, 65,451 without).
- In-hospital and long-term MACEs were significantly higher in the COPD group (OR: 1.40 and 1.58, respectively).
- Both in-hospital and long-term mortality were significantly higher in patients with COPD (OR: 2.25 and 2.22, respectively).
Conclusions:
- COPD is a significant risk factor for increased in-hospital and long-term MACEs and mortality after PCI.
- These findings underscore the importance of considering COPD status in risk stratification for PCI patients.
- Further analysis is warranted for the highly heterogeneous results observed in long-term mortality.
Background:
We aimed to systematically compare Major Adverse Cardiac Events (MACEs) and mortality following Percutaneous Coronary Intervention (PCI) in patients with and without Chronic Obstructive Pulmonary Diseases (COPD) through a meta-analysis.
Methods:
Electronic databases (Cochrane library, EMBASE and Medline/PubMed) were searched for English publications comparing in-hospital and long-term MACEs and mortality following PCI in patients with a past medical history of COPD. Statistical analysis was carried out by Revman 5.3 whereby Odds Ratio (OR) and 95% Confidence Intervals (CI) were considered the relevant parameters.
Results:
A total number of 72,969 patients were included (7518 patients with COPD and 65,451 patients without COPD). Results of this analysis showed that in-hospital MACEs were significantly higher in the COPD group with OR: 1.40, 95% CI: 1.19-1.65; P = 0.0001, I2 = 0%. Long-term MACEs were still significantly higher in the COPD group with OR: 1.58, 95% CI: 1.38-1.81; P = 0.00001, I2 = 29%. Similarly, in-hospital and long-term mortality were significantly higher in patients with COPD, with OR: 2.25, 95% CI: 1.78-2.85; P = 0.00001, I2 = 0% and OR: 2.22, 95% CI: 1.33-3.71; P = 0.002, I2 = 97% respectively. However, the result for the long-term death was highly heterogeneous.
Conclusion:
Since in-hospital and long-term MACEs and mortality were significantly higher following PCI in patients with versus without COPD, COPD should be considered a risk factor for the development of adverse clinical outcomes following PCI. However, the result for the long-term mortality was highly heterogeneous warranting further analysis.
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