PMID- 34302313
OWN - NLM
STAT- MEDLINE
DCOM- 20211103
LR  - 20211103
IS  - 1752-699X (Electronic)
IS  - 1752-6981 (Linking)
VI  - 15
IP  - 11
DP  - 2021 Nov
TI  - Risk of complications rise with coronary artery disease and diabetes mellitus 
      after endobronchial valve placement in severe heterogeneous emphysema.
PG  - 1194-1200
LID - 10.1111/crj.13426 [doi]
AB  - BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) commonly 
      have comorbidities which may impact both symptoms and prognosis. Endoscopic lung 
      volume reduction (ELVR) with endobronchial valves (EBV) is an innovative, 
      effective and safe treatment for patients with severe emphysema who remain 
      symptomatic despite optimal medical therapy. OBJECTIVES: To evaluate medical 
      comorbidities associated with increased risk of complications after EBV 
      procedure. METHOD: This was a retrospective cohort review of patients with 
      severe, heterogeneous emphysema who underwent Zephyr(R) EBV installation for ELVR. 
      Demographics, baseline comorbidities, dyspnea scores, data regarding procedure, 
      pulmonary function test, minimal clinically important difference and post-EBV 
      complications were recorded. RESULTS: Of a total 82 participants, 24 were 
      identified as having a post procedure complication. There was a significant 
      difference in the incidence of type 2 diabetes mellitus (T2DM) at baseline (25%) 
      in complication group compared with non-complication group (5.1%) (p 
      value = 0.01). There was also a significant difference between baseline coronary 
      artery disease (CAD) in those with (58.3%) or without (29.3%) complication 
      (p = 0.01). Multivariate analysis of other covariables, identified associations 
      of both CAD and T2DM with a heightened risk of complication (adjusted OR 4.19 CI: 
      1.23-14.2, p value = 0.02 and adjusted OR of 6.1 CI: 1.3-26.1, p value = 0.02 
      respectively). CONCLUSIONS: Our study found that patients with severe, 
      heterogeneous emphysema who undergo ELVR utilizing Zephyr(R) EBV and suffer 
      complications during post-procedure period are more likely to have CAD or T2DM as 
      baseline comorbidity. These data suggest that baseline CAD and T2DM might be 
      predictive of increased risk of complications following ELVR with EBV.
CI  - (c) 2021 John Wiley & Sons Ltd.
FAU - Fernandez-Bussy, Sebastian
AU  - Fernandez-Bussy S
AD  - Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida, USA.
FAU - Kornafeld, Anna
AU  - Kornafeld A
AUID- ORCID: 0000-0001-8929-2131
AD  - Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida, USA.
FAU - Labarca, Gonzalo
AU  - Labarca G
AUID- ORCID: 0000-0002-0069-3420
AD  - Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, 
      University of Concepcion, Concepcion, Chile.
FAU - Abia-Trujillo, David
AU  - Abia-Trujillo D
AD  - Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida, USA.
FAU - Patel, Neal M
AU  - Patel NM
AD  - Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida, USA.
FAU - Johnson, Margaret M
AU  - Johnson MM
AD  - Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida, USA.
FAU - Reisenauer, Janani S
AU  - Reisenauer JS
AD  - Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
FAU - Herth, Felix J
AU  - Herth FJ
AD  - Department of Pulmonology and Respiratory Care Medicine, Thoraxklinik at the 
      University of Heidelberg, Heidelberg, Germany.
AD  - Translational Lung Research Center Heidelberg (TLRCH), Heidelberg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20210802
PL  - England
TA  - Clin Respir J
JT  - The clinical respiratory journal
JID - 101315570
SB  - IM
MH  - Bronchoscopy
MH  - *Coronary Artery Disease/epidemiology/surgery
MH  - *Diabetes Mellitus, Type 2/complications/epidemiology
MH  - *Emphysema
MH  - Humans
MH  - Pneumonectomy
MH  - *Pulmonary Emphysema/epidemiology/surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - chronic obstructive pulmonary disease
OT  - complications
OT  - coronary artery disease
OT  - endobronchial valves
OT  - severe heterogeneous emphysema
OT  - type 2 diabetes mellitus
EDAT- 2021/07/25 06:00
MHDA- 2021/11/04 06:00
CRDT- 2021/07/24 06:27
PHST- 2021/07/03 00:00 [revised]
PHST- 2021/04/02 00:00 [received]
PHST- 2021/07/15 00:00 [accepted]
PHST- 2021/07/25 06:00 [pubmed]
PHST- 2021/11/04 06:00 [medline]
PHST- 2021/07/24 06:27 [entrez]
AID - 10.1111/crj.13426 [doi]
PST - ppublish
SO  - Clin Respir J. 2021 Nov;15(11):1194-1200. doi: 10.1111/crj.13426. Epub 2021 Aug 
      2.