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Am J Cardiol. 2014 May 1;113(9):1543-9. doi: 10.1016/j.amjcard.2014.01.432. Epub 2014 Feb 12.

Impact of chronic obstructive pulmonary disease on Valve Academic Research Consortium-defined outcomes after transcatheter aortic valve implantation (from the FRANCE 2 Registry).

Author information

1
Department of Cardiology, EA3920, University Hospital Besançon, Besançon, France. Electronic address: rchopard@chu-besancon.fr.
2
Department of Cardiology, EA3920, University Hospital Besançon, Besançon, France.
3
Department of Cardiovascular Surgery, EA3920, University Hospital Besançon, Besançon, France.
4
Department of Cardiology, University Hospital of Brest, Brest, France.
5
Department of Cardiac Surgery, University Hospital Dupuytren, Limoges, France.
6
Department of Cardiology, University Hospital of Rouen, Rouen, France.
7
Department of Cardiology, Bichat-Claude-Bernard Hospital, AP-HP, Paris, France.
8
Department of Cardiology, University Hospital of La Pitié Salpêtrière, Paris, France.
9
Department of Cardiology, University Hospital Henri Mondor, Créteil, France.
10
URC Eco, Hôtel-Dieu, AP-HP, Paris, France.
11
Department of Cardiovascular Surgery, University Hospital of Lille, Lille, France.
12
University Lyon 1, Lyon, France.
13
Division of Thoracic, Cardiac and Vascular Surgery, Rennes University Hospital, Rennes, France.
14
Jacques Cartier Institute, Massy, France.
15
Clinique Pasteur, Toulouse, France.

Abstract

The purposes of the present study were to determine the impact of chronic obstructive pulmonary disease (COPD) on Valve Academic Research Consortium-defined outcomes in patients undergoing transcatheter aortic valve implantation (TAVI). A total of 3,933 consecutive patients underwent TAVI from January 2010 to December 2011 in 34 centers and were included in the French national TAVI registry "FRANCE 2"; 895 (22.7%) had concomitant COPD, 3,038 (77.3%) did not. There were no significant differences in procedural characteristics or 30-day Valve Academic Research Consortium-defined outcomes between those with and without COPD. Multivariate regression analysis showed COPD to be an independent predictor of 1-year mortality and combined efficacy end point after adjustment for concomitant co-morbidities (hazard ratio 1.19, 95% confidence interval 1.005 to 1.41, p = 0.03 and hazard ratio 1.52, 95% confidence interval 1.29 to 1.79, p <0.001, respectively). The higher mortality rate at 1 year in patients with COPD was related to cardiovascular deaths (COPD 10.0% vs non-COPD 6.2%, p = 0.008). Subgroup analysis found that the effect of COPD on 1-year mortality rate was constant across different subgroups, especially the type of approach and the type of anesthesia subgroups. In conclusion, concomitant COPD in patients referred for TAVI characterizes a high-risk population. The excess in mortality is largely determined by a higher rate of cardiovascular deaths and exists regardless of the type of procedure performed and its results.

PMID:
24630784
DOI:
10.1016/j.amjcard.2014.01.432
[Indexed for MEDLINE]

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