Impact of Chronic Obstructive Pulmonary Disease on Outcomes After Transcatheter Mitral Valve Repair
Sitammagari K, Dhanireddy BR, Kondamareddy D, Gangani K, Dontaraju V, Ninan J, and Villablanca P. Impact of Chronic Obstructive Pulmonary Disease on Outcomes After Transcatheter Mitral Valve Repair. JACC: Cardiovasc Interv 2020; 13(4):S57-S58.
JACC: Cardiovasc Interv
Background: Chronic obstructive pulmonary disease (COPD) is associated with increased mortality and morbidity after cardiac valve surgeries and coronary angioplasty. However, the association of COPD with in-hospital outcomes after transcatheter mitral valve repair (TMVr) has not been established. Methods: Elective TMVr procedures among adults were identified using the National Readmissions Database (NRD) from January 2012 to August 2015. ICD-9 codes were used to identify patients with and without COPD. Multivariate linear and logistic regressions were used to calculate odds ratios for primary and secondary outcomes after adjusting for confounders. Primary outcomes were all-cause in-hospital mortality and associated in-hospital complications after TMVr in COPD vs non-COPD patients. Results: Of the 1,741 patients who underwent TMVr procedures during the study period, 256 (14.7%) had documented COPD. Patients with COPD were more likely to have a high burden of comorbidities (CCI 2 vs 1, p<0.001), including congestive heart failure, long-term oxygen dependence, dyslipidemia, obesity, smoking, and prior coronary artery disease (p<0.05 for all). There was no significant difference in all-cause in-hospital mortality (aOR 0.76, p=0.583), major bleeding (aOR 0.86, p=0.367), pacemaker placement (aOR 0.93, p=0.771), acute kidney injury (aOR 0.90, p=0.642), home discharge (aOR 1.15, p=0.367), and mean length of hospitalization (aOR -0.35, p=0.550). Patients with COPD were more likely to be discharged to a skilled nursing facility (aOR 1.80, 95% CI 1.24-2.73, p=0.007) compared to non-COPD patients. Conclusion: COPD did not impact in-hospital mortality or post-operative outcomes after TMVr. However, further studies are needed to evaluate the effect of COPD on long-term outcomes after TMVr.