Jonas Rusnak1, Michael Behnes2, Tobias Schupp1, Linda Reiser1, Armin Bollow1, Gabriel Taton1, Thomas Reichelt1, Dominik Ellguth1, Niko Engelke1, Jorge Hoppner3, Kathrin Weidner1, Ibrahim El-Battrawy1, Kambis Mashayekhi4, Christel Weiß5, Martin Borggrefe1, Ibrahim Akin1. 1. First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany. 2. First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Mannheim, Germany. Electronic address: michael.behnes@umm.de. 3. Department of Diagnostic and Interventional Radiology, University Heidelberg, Heidelberg, Germany. 4. Department of Cardiology and Angiology II, University Heart Center Freiburg, Bad Krozingen, Germany. 5. Institute of Biomathematics and Medical Statistics, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, Heidelberg University, Mannheim, Germany.
Abstract
OBJECTIVES: The study sought to assess the prognostic impact of COPD in patients presenting with ventricular tachyarrhythmias and sudden cardiac arrest (SCA) on admission. BACKGROUND: Data regarding the outcome of patients with COPD presenting with ventricular tachyarrhythmias and SCA is limited. METHODS: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT), fibrillation (VF) and SCA from 2002 to 2016. Patients with COPD were compared to patients without COPD applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint defined as long-term all-cause mortality at 2 years. Secondary endpoints were all-cause mortality at index, at 30 days and after discharge, cardiac death at 24 h, rehospitalization related to cardiac causes and the composite endpoint of cardiac death at 24 h, recurrences of ventricular tachyarrhythmias and appropriate ICD therapies at 2 years. RESULTS: In 2813 unmatched high-risk patients with ventricular tachyarrhythmias and SCA, COPD was present in 9%. VF was less common in COPD (28% versus 39%; p = 0.001). Multivariable Cox regression models revealed that COPD was associated with the primary endpoint of long-term all-cause mortality (HR = 1.245; 95% CI 1.001-1.549; p = 0.001), which was also proven after propensity score matching (log rank p = 0.001). The secondary endpoints of all-cause mortality at index, at 30 days, after discharge, cardiac death at 24 h, as well as the composite endpoint of cardiac death at 24 h, recurrences of ventricular tachyarrhythmias and appropriate ICD therapies were higher in COPD (p < 0.033). CONCLUSION: In high-risk patients presenting with ventricular tachyarrhythmias and SCA, COPD was associated with higher long-term all-cause mortality, cardiac death at 24 h and higher rates of the composite endpoint of cardiac death at 24 h, recurrences of ventricular tachyarrhythmias and appropriate ICD therapies at 2 years.
OBJECTIVES: The study sought to assess the prognostic impact of COPD in patients presenting with ventricular tachyarrhythmias and sudden cardiac arrest (SCA) on admission. BACKGROUND: Data regarding the outcome of patients with COPD presenting with ventricular tachyarrhythmias and SCA is limited. METHODS: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT), fibrillation (VF) and SCA from 2002 to 2016. Patients with COPD were compared to patients without COPD applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint defined as long-term all-cause mortality at 2 years. Secondary endpoints were all-cause mortality at index, at 30 days and after discharge, cardiac death at 24 h, rehospitalization related to cardiac causes and the composite endpoint of cardiac death at 24 h, recurrences of ventricular tachyarrhythmias and appropriate ICD therapies at 2 years. RESULTS: In 2813 unmatched high-risk patients with ventricular tachyarrhythmias and SCA, COPD was present in 9%. VF was less common in COPD (28% versus 39%; p = 0.001). Multivariable Cox regression models revealed that COPD was associated with the primary endpoint of long-term all-cause mortality (HR = 1.245; 95% CI 1.001-1.549; p = 0.001), which was also proven after propensity score matching (log rank p = 0.001). The secondary endpoints of all-cause mortality at index, at 30 days, after discharge, cardiac death at 24 h, as well as the composite endpoint of cardiac death at 24 h, recurrences of ventricular tachyarrhythmias and appropriate ICD therapies were higher in COPD (p < 0.033). CONCLUSION: In high-risk patients presenting with ventricular tachyarrhythmias and SCA, COPD was associated with higher long-term all-cause mortality, cardiac death at 24 h and higher rates of the composite endpoint of cardiac death at 24 h, recurrences of ventricular tachyarrhythmias and appropriate ICD therapies at 2 years.