Risk of Death and Cardiovascular Events in Asian Patients With Atrial Fibrillation and Chronic Obstructive Pulmonary Disease: A Report From the Prospective APHRS Registry
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Published:2024-04-02
Issue:7
Volume:13
Page:
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ISSN:2047-9980
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Container-title:Journal of the American Heart Association
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language:en
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Short-container-title:JAHA
Author:
Bucci Tommaso12ORCID, Romiti Giulio Francesco13ORCID, Shantsila Alena1ORCID, Teo Wee‐Siong4, Park Hyung‐Wook5ORCID, Shimizu Wataru6ORCID, Corica Bernadette13ORCID, Proietti Marco78ORCID, Tse Hung‐Fat9ORCID, Chao Tze‐Fan1011, Frost Frederick1, Lip Gregory Y. H.112ORCID, David Chun‐Wah Siu, Shimizu Wataru, Yodogawa Kenji, Tsutsui Hiroyuki, Mukai Yasushi, Tomita Hirofumi, Horiuchi Daisuke, Hagii Joji, Aonuma Kazutaka, Okumura Yasuo, Goya Masahiko, Hirao Kenzo, Hagiwara Nobuhisa, Suzuki Atsushi, Yamane Teiichi, Ikeda Takanori, Yuzawa Hitomi, Satomi Kazuhiro, Yazaki Yoshinao, Fukuda Keiichi, Kobayashi Yoshinori, Morita Norishige, Murohara Toyoaki, Watanabe Eiichi, Harada Masahide, Sakagami Satoru, Saeki Takahiro, Kusano Kengo, Miyamoto Koji, Miyazaki Shinsuke, Tada Hiroshi, Inoue Koichi, Tanaka Nobuaki, Koretsune Yukihiro, Abe Haruhiko, Kihara Yasuki, Nakano Yukiko, Shimizu Akihiko, Yoshiga Yasuhiro, Sakamoto Tomohiro, Okumura Ken, Takahashi Naohiko, Shinohara Tetsuji, Soejima Kyoko, Takagi Masahiko, Kawamura Mitsuharu, Munetsugu Yumi, Kim Sung‐Hwan, Shim Jae‐Min, Uhm Jae Sun, Im Sung Il, Par Hyoung‐Seob, Kim Jun Hyung, On Young Keun, Oh Il‐Young, Shin Seung Yong, Ko Jum Suk, Park Jun Beom, Teo Wee‐Siong, Wong Kelvin Cheok‐Keng, Lim Toon‐Wei, Foo David, Chen Shih‐Ann, Chen Shih‐Ann, Chao Tze‐Fan, Lin YennJiang, Chung Fa‐Po, Hu Yu‐Feng, Chang Shil‐Lin, Tuan Ta‐Chuan, Liao Jo‐Nan, Li Cheng‐Hung, Huang Jin‐Long, Hsieh Yu‐Cheng, Wu Tsu‐Juey, Liao Ying‐Chieh, Chiang Cheng‐Hung, Hsiao Hsiang‐Chiang, Yeh Tung‐Chen, Lin Wei‐Siang, Lin Wen‐Yu, Kuo Jen‐Yuan, Hong Chong‐Lie, Wu Yih‐Je, Li Ying‐Siang, Tsai Jui‐Peng, Sung Kuo‐Tzu, Chang Sheng‐Hsiung
Affiliation:
1. Liverpool Centre of Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UK 2. Department of General and Specialized Surgery Sapienza University of Rome Rome Italy 3. Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy 4. Department of Cardiology National Heart Centre Singapore Singapore 5. Department of Cardiovascular Medicine Chonnam National University Hospital Gwangju Korea 6. Department of Cardiovascular Medicine Nippon Medical School Tokyo Japan 7. Department of Clinical Sciences and Community Health University of Milan Milan Italy 8. Division of Subacute Care IRCCS Istituti Clinici Scientifici Maugeri Milan Italy 9. Department of Medicine, School of Clinical Medicine; Queen Mary Hospital The University of Hong Kong Hong Kong SAR China 10. Institute of Clinical Medicine, and Cardiovascular Research Center National Yang Ming Chiao Tung University Taipei Taiwan 11. Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan 12. Danish Center for Health Services Research, Department of Clinical Medicine Aalborg University Aalborg Denmark
Abstract
Background
Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of adverse events in patients with atrial fibrillation (AF); however, few data are available on this topic in Asian populations.
Methods and Results
Prospective observational study conducted on patients with AF enrolled in the Asia‐Pacific Heart Rhythm Society (APHRS) AF Registry. The diagnosis of COPD was based on data reported in the case report form by the investigators. Cox‐regression models were used to assess the 1‐year risk of a primary composite outcome of all‐cause death, thromboembolic events, acute coronary syndrome, and heart failure. Analysis on single outcomes and cardiovascular death was also performed. Interaction analysis was used to assess the risk of composite outcome and all‐cause death in different subgroups. The study included 4094 patients with AF (mean±SD age 68.5±12 years, 34.6% female), of whom 112 (2.7%) had COPD. Patients with COPD showed a higher incidence of the primary composite outcome (25.1% versus 6.3%,
P
<0.001), all‐cause death (14.9% versus 2.6%,
P
<0.001), cardiovascular death (2.0% versus 0.6%,
P
<0.001), and heart failure (8.3% versus 6.0%,
P
<0.001). On multiple Cox‐regression analysis, COPD was associated with a higher risk of the primary composite outcome (hazard ratio [HR], 3.17 [95% CI, 2.05–4.90]), all‐cause death (HR, 3.59 [95% CI, 2.04–6.30]), and heart failure (HR, 3.32 [95% CI, 1.56–7.03]); no statistically significant differences were found for other outcomes. The association between COPD and mortality was significantly modified by the use of beta blockers (
P
int
=0.018).
Conclusions
In Asian patients with AF, COPD is associated with worse prognosis. In patients with AF and COPD, the use of beta blockers was associated with a lower mortality.
Registration Information
clinicaltrials.gov
Identifier:
NCT04807049
.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Cited by
2 articles.
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