Romiti, Giulio Francesco, Corica, Bernadette 
ORCID: 0000-0001-9460-4435, Mei, Davide Antonio, Frost, Frederick ORCID: 0000-0002-3902-6502, Bisson, Arnaud, Boriani, Giuseppe, Bucci, Tommaso, Olshansky, Brian, Chao, Tze-Fan, Huisman, Menno V et al (show 2 more authors)
(2024)
Impact of chronic obstructive pulmonary disease in patients with atrial fibrillation: an analysis from the GLORIA-AF registry.
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 26 (1).
euae021-euae021.
Abstract
<h4>Aims</h4>Chronic obstructive pulmonary disease (COPD) may influence management and prognosis of atrial fibrillation (AF), but this relationship has been scarcely explored in contemporary global cohorts. We aimed to investigate the association between AF and COPD, in relation to treatment patterns and major outcomes.<h4>Methods and results</h4>From the prospective, global GLORIA-AF registry, we analysed factors associated with COPD diagnosis, as well as treatment patterns and risk of major outcomes in relation to COPD. The primary outcome was the composite of all-cause death and major adverse cardiovascular events (MACEs). A total of 36 263 patients (mean age 70.1 ± 10.5 years, 45.2% females) were included; 2,261 (6.2%) had COPD. The prevalence of COPD was lower in Asia and higher in North America. Age, female sex, smoking, body mass index, and cardiovascular comorbidities were associated with the presence of COPD. Chronic obstructive pulmonary disease was associated with higher use of oral anticoagulant (OAC) [adjusted odds ratio (aOR) and 95% confidence interval (CI): 1.29 (1.13-1.47)] and higher OAC discontinuation [adjusted hazard ratio (aHR) and 95% CI: 1.12 (1.01-1.25)]. Chronic obstructive pulmonary disease was associated with less use of beta-blocker [aOR (95% CI): 0.79 (0.72-0.87)], amiodarone and propafenone, and higher use of digoxin and verapamil/diltiazem. Patients with COPD had a higher hazard of primary composite outcome [aHR (95% CI): 1.78 (1.58-2.00)]; no interaction was observed regarding beta-blocker use. Chronic obstructive pulmonary disease was also associated with all-cause death [aHR (95% CI): 2.01 (1.77-2.28)], MACEs [aHR (95% CI): 1.41 (1.18-1.68)], and major bleeding [aHR (95% CI): 1.48 (1.16-1.88)].<h4>Conclusion</h4>In AF patients, COPD was associated with differences in OAC treatment and use of other drugs; Patients with AF and COPD had worse outcomes, including higher mortality, MACE, and major bleeding.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Pulmonary Disease, Chronic Obstructive, Atrial Fibrillation, Hemorrhage, Anticoagulants, Registries, Risk Factors, Prospective Studies, Aged, Aged, 80 and over, Middle Aged, Female, Male, Stroke |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 14 Feb 2024 11:17 |
| Last Modified: | 14 Feb 2024 11:18 |
| DOI: | 10.1093/europace/euae021 |
| Open Access URL: | https://doi.org/10.1093/europace/euae021 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3178645 |
Dimensions
Dimensions
