Risk of Death and Cardiovascular Events in Asian Patients With Atrial Fibrillation and Chronic Obstructive Pulmonary Disease: A Report From the Prospective APHRS Registry.


Bucci, Tommaso ORCID: 0000-0003-2895-6234, Romiti, Giulio Francesco ORCID: 0000-0002-3788-8942, Shantsila, Alena ORCID: 0000-0002-0594-8576, Teo, Wee-Siong, Park, Hyung-Wook ORCID: 0000-0002-9630-0467, Shimizu, Wataru ORCID: 0000-0001-9941-8973, Corica, Bernadette ORCID: 0000-0001-9460-4435, Proietti, Marco ORCID: 0000-0003-1452-2478, Tse, Hung-Fat ORCID: 0000-0002-9578-7808, Chao, Tze-Fan et al (show 3 more authors) (2024) Risk of Death and Cardiovascular Events in Asian Patients With Atrial Fibrillation and Chronic Obstructive Pulmonary Disease: A Report From the Prospective APHRS Registry. Journal of the American Heart Association, 13 (7). e032785-.

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Abstract

<h4>Background</h4>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.<h4>Methods and results</h4>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%, <i>P</i><0.001), all-cause death (14.9% versus 2.6%, <i>P</i><0.001), cardiovascular death (2.0% versus 0.6%, <i>P</i><0.001), and heart failure (8.3% versus 6.0%, <i>P</i><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 (<i>P</i><sub>int</sub>=0.018).<h4>Conclusions</h4>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.<h4>Registration information</h4>clinicaltrials.gov Identifier: NCT04807049.

Item Type: Article
Uncontrolled Keywords: Asia‐Pacific Heart Rhythm Society Atrial Fibrillation Registry Investigators, Humans, Pulmonary Disease, Chronic Obstructive, Atrial Fibrillation, Adrenergic beta-Antagonists, Registries, Risk Factors, Prospective Studies, Aged, Aged, 80 and over, Middle Aged, Asia, Female, Male, Heart Failure
Divisions: Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Faculty of Health and Life Sciences
Depositing User: Symplectic Admin
Date Deposited: 03 Apr 2024 14:14
Last Modified: 13 Apr 2024 02:12
DOI: 10.1161/jaha.123.032785
Open Access URL: https://www.ahajournals.org/doi/10.1161/JAHA.123.0...
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3180033
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