The impact of chronic obstructive pulmonary disease on the prognosis outcomes of patients with percutaneous coronary intervention or coronary artery bypass grafting: A meta-analysis

Background Coronary artery disease (CAD) is one of the main types of cardiovascular disease and is characterized by myocardial ischemia as a result of narrowing of the coronary arteries. Objective To evaluate the impact of chronic obstructive pulmonary disease (COPD) on outcomes in patients with CAD treated by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Methods We searched PubMed, Embase, Web of Science, and Cochrane Library for observational studies and post-hoc analyses of randomized controlled trials published before Jan 20, 2022, in English. Adjusted odds ratios (ORs), risk ratios (RRs), and hazard ratios (HRs) for short-term outcomes (in-hospital and 30-day all-cause mortality) and long-term outcomes (all-cause mortality, cardiac death, major adverse cardiac events) were extracted or transformed. Results Nineteen studies were included. The risk of short-term all-cause mortality was significantly higher in patients with COPD than in those without COPD (RR 1.42, 95% CI 1.05–1.93), as were the risks of long-term all-cause mortality (RR 1.68, 95% CI 1.50–1.88) and long-term cardiac mortality (HR 1.84, 95% CI 1.41–2.41). There was no significant between-group difference in the long-term revascularization rate (HR 1.01, 95% CI 0.99–1.04) or in short-term and long-term stroke rates (OR 0.89, 95% CI 0.58–1.37 and HR 1.38, 95% CI 0.97–1.95). Operation significantly affected heterogeneity and combined results for long-term mortality (CABG, HR 1.32, 95% CI 1.04–1.66; PCI, HR 1.84, 95% CI 1.58–2.13). Conclusions COPD was independently associated with poor outcomes after PCI or CABG after adjustment for confounders.