Giulio Francesco Romiti1, Bernadette Corica1, Eugenia Pipitone2, Marco Vitolo3,4,5, Valeria Raparelli6,7, Stefania Basili1, Giuseppe Boriani3, Sergio Harari8,9,10, Gregory Y H Lip4,11, Marco Proietti4,10,12. 1. Department of Translational and Precision Medicine, Sapienza-University of Rome, Viale del Policlinico 155, 00161 Rome, Italy. 2. Ospedale Regionale "Beata Vergine", Via Turconi 23, 6850 Mendrisio, Switzerland. 3. Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, via Giuseppe Campi 287, 41125, Modena, Italy. 4. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Brownlow Hill, L69 7TX Liverpool, UK. 5. Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, via Giuseppe Campi 287, 41125 Modena, Italy. 6. Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121 Italy. 7. University of Alberta, Faculty of Nursing, 11405-87 Avenue, T6G 1C9 Edmonton, Alberta, Canada. 8. U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria-Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare, Ospedale San Giuseppe-MultiMedica IRCCS, Via San Vittore 12, 20123 Milan, Italy. 9. Department of Medical Sciences, San Giuseppe Hospital MultiMedica IRCCS, Via San Vittore 12, 20123 Milan, Italy. 10. Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy. 11. Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, 9000 Aalborg, Denmark. 12. Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, Milano 20138, Italy.
Abstract
AIM: Prevalence of chronic obstructive pulmonary disease (COPD) in atrial fibrillation (AF) patients is unclear, and its association with adverse outcomes is often overlooked. Our aim was to estimate the prevalence of COPD, its impact on clinical management and outcomes in patients with AF, and the impact of beta-blockers (BBs) on outcomes in patients with COPD. METHODS AND RESULTS: A systematic review and meta-analysis was conducted according to international guidelines. All studies reporting the prevalence of COPD in AF patients were included. Data on comorbidities, BBs and oral anticoagulant prescription, and outcomes (all-cause death, cardiovascular (CV) death, ischaemic stroke, major bleeding) were compared according to COPD and BB status. Among 46 studies, pooled prevalence of COPD was 13% [95% confidence intervals (CI) 10-16%, 95% prediction interval 2-47%]. COPD was associated with higher prevalence of comorbidities, higher CHA2DS2-VASc score and lower BB prescription [odds ratio (OR) 0.77, 95% CI 0.61-0.98]. COPD was associated with higher risk of all-cause death (OR 2.22, 95% CI 1.93-2.55), CV death (OR 1.84, 95% CI 1.39-2.43), and major bleeding (OR 1.45, 95% CI 1.17-1.80); no significant differences in outcomes were observed according to BB use in AF patients with COPD. CONCLUSION: COPD is common in AF, being found in 13% of patients, and is associated with increased burden of comorbidities, differential management, and worse outcomes, with more than a two-fold higher risk of all-cause death and increased risk of CV death and major bleeding. Therapy with BBs does not increase the risk of adverse outcomes in patients with AF and COPD. Published on behalf of the European Society of Cardiology. All rights reserved.
AIM: Prevalence of chronic obstructive pulmonary disease (COPD) in atrial fibrillation (AF) patients is unclear, and its association with adverse outcomes is often overlooked. Our aim was to estimate the prevalence of COPD, its impact on clinical management and outcomes in patients with AF, and the impact of beta-blockers (BBs) on outcomes in patients with COPD. METHODS AND RESULTS: A systematic review and meta-analysis was conducted according to international guidelines. All studies reporting the prevalence of COPD in AF patients were included. Data on comorbidities, BBs and oral anticoagulant prescription, and outcomes (all-cause death, cardiovascular (CV) death, ischaemic stroke, major bleeding) were compared according to COPD and BB status. Among 46 studies, pooled prevalence of COPD was 13% [95% confidence intervals (CI) 10-16%, 95% prediction interval 2-47%]. COPD was associated with higher prevalence of comorbidities, higher CHA2DS2-VASc score and lower BB prescription [odds ratio (OR) 0.77, 95% CI 0.61-0.98]. COPD was associated with higher risk of all-cause death (OR 2.22, 95% CI 1.93-2.55), CV death (OR 1.84, 95% CI 1.39-2.43), and major bleeding (OR 1.45, 95% CI 1.17-1.80); no significant differences in outcomes were observed according to BB use in AF patients with COPD. CONCLUSION: COPD is common in AF, being found in 13% of patients, and is associated with increased burden of comorbidities, differential management, and worse outcomes, with more than a two-fold higher risk of all-cause death and increased risk of CV death and major bleeding. Therapy with BBs does not increase the risk of adverse outcomes in patients with AF and COPD. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Giuseppe Boriani; Saverio Iacopino; Giuseppe Arena; Paolo Pieragnoli; Roberto Verlato; Massimiliano Manfrin; Giulio Molon; Giovanni Rovaris; Antonio Curnis; Giovanni Battista Perego; Antonio Dello Russo; Maurizio Landolina; Marco Vitolo; Claudio Tondo Journal: J Cardiovasc Dev Dis Date: 2022-04-21
Authors: Rachel M J van der Velden; Astrid N L Hermans; Nikki A H A Pluymaekers; Monika Gawalko; Adrian Elliott; Jeroen M Hendriks; Frits M E Franssen; Annelies M Slats; Vanessa P M van Empel; Isabelle C Van Gelder; Dick H J Thijssen; Thijs M H Eijsvogels; Carsten Leue; Harry J G M Crijns; Dominik Linz; Sami O Simons Journal: Int J Cardiol Heart Vasc Date: 2022-07-19
Authors: Giulio Francesco Romiti; Marco Proietti; Giuseppe Boriani; Gregory Y H Lip; Marco Vitolo; Niccolò Bonini; Ameenathul Mazaya Fawzy; Wern Yew Ding; Laurent Fauchier; Francisco Marin; Michael Nabauer; Gheorghe Andrei Dan; Tatjana S Potpara Journal: BMC Med Date: 2022-09-02 Impact factor: 11.150