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Chronic obstructive pulmonary disease is associated with increased mortality in patients undergoing MitraClip therapy: A systematic review and meta-analysis

Chanavuth Kanitsoraphan, Jakrin Kewcharoen, Chol Techorueangwiwat, Pattara Rattanawong

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is highly prevalent in patients undergoing MitraClip with up to 39% reported. Nonetheless, whether COPD has effect on mortality in this patient population remains unclear. We conduct a systematic review and meta-analysis to evaluate the effect of COPD on the outcome in patient undergoing MitraClip therapy.

Methods: We comprehensively searched the data bases of MEDLINE and EMBASE from inception to August 2020. Published cohort and randomized controlled trials of patients undergoing MitraClip therapy which reported univariate or multivariate analyses on the effect of COPD to mortality were included. Data were integrated using the random-effects, generic inverse variance method of DerSimonian and Laird.

Results: Six studies from 2014-2018 involving 5,076 patients undergoing MitraClip therapy were included. Baseline COPD was associated with increased mortality (Risk Ratio [RR]=1.22, 95% Confidence Interval [CI]: 1.07-1.38, p=0.002, I2=0.00%).

Conclusion: COPD is associated with increased mortality in patient undergoing MitraClip therapy up to 1.22 folds. Therefore, COPD could be a predictor of outcome in patients undergoing Mitraclip therapy and could be potentially integrated in risk stratification in this patient population.