Valvular & structural heart disease
Mortality in patients with chronic obstructive pulmonary disorder undergoing transcatheter aortic valve replacement: The importance of chronic obstructive pulmonary disease exacerbation
Authors' conclusion
Among patients undergoing TAVR, increasing risk of exacerbation with COPD was associated with increasing 1-year mortality compared with non-COPD patients. Patients with a high risk of exacerbation with COPD not using any guideline recommended COPD medication and those using home oxygen had the highest 1-year mortality.
Study context
- Population
- Patients undergoing first-time transcatheter aortic valve replacement (TAVR) in Denmark, 2008–2021median age 81.4 years
- Participants
- 7,047 patients
- Exposure
- Chronic obstructive pulmonary disease (COPD) severity groups vs no COPD
- COPDn = 644
- Low risk of acute exacerbation of COPD (AE-COPD)n = 439
- High risk of AE-COPDn = 205
- Outcome
- All-cause mortality
- Follow-up
- 1 year after TAVR
Methodological detailsDanish nationwide registries, adjusted Cox regression
- Danish nationwide registries
- Adjusted Cox regression
Main finding
As reported in the abstract
1-year mortality
Each group vs no COPDAdjusted hazard ratio (95% CI)
COPD
1.63(1.28–2.07)
Low risk of AE-COPD
1.31(0.97–1.78)
High risk of AE-COPD
2.44(1.70–3.50)
Observational data: associations, not effects.
Further findings
Percent
High risk, no/short-term therapy
31.6%(95% CI 14.5–48.7)
High risk, home oxygen
30.9%(95% CI 10.3–51.6)
- Highest 1-year mortality subgroups
Original publication
Mortality in patients with chronic obstructive pulmonary disorder undergoing transcatheter aortic valve replacement: The importance of chronic obstructive pulmonary disease exacerbation. Am Heart J. Published 26 April 2023. doi:10.
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