Bi Huang1, Yanmin Yang2, Jun Zhu1, Yan Liang1, Han Zhang1, Li Tian1, Xinghui Shao1, Juan Wang1. 1. State Key Laboratory of Cardiovascular Disease, Emergency and Critical Care Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. 2. State Key Laboratory of Cardiovascular Disease, Emergency and Critical Care Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. Electronic address: yangymfuwai@163.com.
Abstract
OBJECTIVES: Atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD) are 2 common morbidities and often coexist. Studies have shown that COPD is a risk factor for cardiovascular disease, but the characteristics in patients with COPD and AF, as well as the impact of COPD on the outcomes of AF were lacking. The aim of present study was to analyze the clinical characteristics and to evaluate the association of COPD with 1-year outcomes in patients with AF. DESIGN: Longitudinal observational study. PARTICIPANTS: A total of 1975 consecutive patients with AF were registered. Patients were divided into COPD group and non-COPD group according to whether AF coexisted with COPD. MEASUREMENTS: Outcome measures included all-cause mortality, stroke, and major adverse events (MAE) during 1-year follow-up. RESULTS: A group of 227 (11.5%) patients had concomitant COPD. Compared with non-COPD patients, patients with COPD were older and tended to have other coexisting cardiovascular morbidities, and had a significantly higher percentage of smoking history. Anticoagulation with warfarin was adopted by only a few patients both with and without COPD. During 1-year follow-up, the all-cause mortality and major adverse event rate in the COPD group were significantly higher than that of non-COPD group (26.9% vs 12.3%, P < .001 and 25.6% vs 19.1%, P = .027, respectively), whereas the incidence of stroke in the 2 groups was comparable (7.9% vs 7.4%, P = .788). Moreover, the cause-specific mortality between the 2 groups was comparable. After multivariate adjustments, COPD was still an independent risk factor for both 1-year all-cause mortality [hazard rate (HR) = 1.491, 95% confidence interval (CI) 1.110-2.002, P = .008] and cardiovascular mortality (HR = 1.595, 95% CI 1.071-2.376, P = .022), but not a risk factor for stroke (HR = 0.879, 95% CI 0.527-1.464, P = .620). CONCLUSIONS: Anticoagulation treatment is inadequate in patients with AF and COPD. The presence of COPD in patients with AF is an independent risk factor for 1-year all-cause mortality and cardiovascular mortality but not a risk factor for stroke.
OBJECTIVES:Atrial fibrillation (AF) and chronic obstructive pulmonary disease (COPD) are 2 common morbidities and often coexist. Studies have shown that COPD is a risk factor for cardiovascular disease, but the characteristics in patients with COPD and AF, as well as the impact of COPD on the outcomes of AF were lacking. The aim of present study was to analyze the clinical characteristics and to evaluate the association of COPD with 1-year outcomes in patients with AF. DESIGN: Longitudinal observational study. PARTICIPANTS: A total of 1975 consecutive patients with AF were registered. Patients were divided into COPD group and non-COPD group according to whether AF coexisted with COPD. MEASUREMENTS: Outcome measures included all-cause mortality, stroke, and major adverse events (MAE) during 1-year follow-up. RESULTS: A group of 227 (11.5%) patients had concomitant COPD. Compared with non-COPDpatients, patients with COPD were older and tended to have other coexisting cardiovascular morbidities, and had a significantly higher percentage of smoking history. Anticoagulation with warfarin was adopted by only a few patients both with and without COPD. During 1-year follow-up, the all-cause mortality and major adverse event rate in the COPD group were significantly higher than that of non-COPD group (26.9% vs 12.3%, P < .001 and 25.6% vs 19.1%, P = .027, respectively), whereas the incidence of stroke in the 2 groups was comparable (7.9% vs 7.4%, P = .788). Moreover, the cause-specific mortality between the 2 groups was comparable. After multivariate adjustments, COPD was still an independent risk factor for both 1-year all-cause mortality [hazard rate (HR) = 1.491, 95% confidence interval (CI) 1.110-2.002, P = .008] and cardiovascular mortality (HR = 1.595, 95% CI 1.071-2.376, P = .022), but not a risk factor for stroke (HR = 0.879, 95% CI 0.527-1.464, P = .620). CONCLUSIONS: Anticoagulation treatment is inadequate in patients with AF and COPD. The presence of COPD in patients with AF is an independent risk factor for 1-year all-cause mortality and cardiovascular mortality but not a risk factor for stroke.
Authors: Moisés Rodríguez-Mañero; Estrella López-Pardo; Alberto Cordero; Alberto Ruano-Ravina; José Novo-Platas; María Pereira-Vázquez; Álvaro Martínez-Gómez; Javier García-Seara; Jose-Luis Martínez-Sande; Carlos Peña-Gil; Pilar Mazón; Jose María García-Acuña; Luis Valdés-Cuadrado; José Ramón González-Juanatey Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-02-12
Authors: Bhautesh Dinesh Jani; Barbara I Nicholl; Ross McQueenie; Derek T Connelly; Peter Hanlon; Katie I Gallacher; Duncan Lee; Frances S Mair Journal: Europace Date: 2018-11-01 Impact factor: 5.214