Major adverse cardiac events and mortality in chronic obstructive pulmonary disease following percutaneous coronary intervention: a systematic review and meta-analysis

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. 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. 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, I 2 = 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, I 2 = 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, I 2 = 0% and OR: 2.22, 95% CI: 1.33–3.71; P = 0.002, I 2 = 97% respectively. However, the result for the long-term death was highly heterogeneous. 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.