PDF(Pubmed)
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.
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 (Pint=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.
UNASSIGNED: clinicaltrials.gov Identifier: NCT04807049.
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 (Pint=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.
UNASSIGNED: clinicaltrials.gov Identifier: NCT04807049.
摘要：
背景：慢性阻塞性肺疾病（COPD）与房颤（AF）患者的不良事件风险增加有关；然而，在亚洲人群中，关于这一主题的数据很少。
结果：对亚太心律协会(APHRS)房颤注册登记的房颤患者进行的前瞻性观察性研究。COPD的诊断基于研究者在病例报告表中报告的数据。Cox回归模型用于评估全因死亡的主要复合结局的1年风险。血栓栓塞事件,急性冠脉综合征,和心力衰竭。还对单一结局和心血管死亡进行了分析。使用相互作用分析评估不同亚组的复合结局和全因死亡的风险。本研究纳入4094例房颤患者(平均±SD年龄68.5±12岁,34.6%女性)，其中112人(2.7%)患有COPD。COPD患者的主要复合结局发生率较高（25.1%对6.3%，P<0.001)，全因死亡(14.9%对2.6%，P<0.001)，心血管死亡（2.0%对0.6%，P<0.001)，和心力衰竭(8.3%对6.0%，P<0.001)。关于多元Cox回归分析，COPD与主要复合结局的高风险相关(风险比[HR]，3.17[95%CI，2.05-4.90])，全因死亡(HR，3.59[95%CI，2.04-6.30])，和心力衰竭（HR，3.32[95%CI，1.56-7.03]）；其他结果无统计学差异。使用β受体阻滞剂可显着改变COPD与死亡率之间的关系（Pint=0.018）。
结论：在亚洲房颤患者中，COPD与预后较差相关。在房颤和COPD患者中，β受体阻滞剂的使用与较低的死亡率相关.
■clinicaltrials.gov标识符：NCT04807049。
结果：对亚太心律协会(APHRS)房颤注册登记的房颤患者进行的前瞻性观察性研究。COPD的诊断基于研究者在病例报告表中报告的数据。Cox回归模型用于评估全因死亡的主要复合结局的1年风险。血栓栓塞事件,急性冠脉综合征,和心力衰竭。还对单一结局和心血管死亡进行了分析。使用相互作用分析评估不同亚组的复合结局和全因死亡的风险。本研究纳入4094例房颤患者(平均±SD年龄68.5±12岁,34.6%女性)，其中112人(2.7%)患有COPD。COPD患者的主要复合结局发生率较高（25.1%对6.3%，P<0.001)，全因死亡(14.9%对2.6%，P<0.001)，心血管死亡（2.0%对0.6%，P<0.001)，和心力衰竭(8.3%对6.0%，P<0.001)。关于多元Cox回归分析，COPD与主要复合结局的高风险相关(风险比[HR]，3.17[95%CI，2.05-4.90])，全因死亡(HR，3.59[95%CI，2.04-6.30])，和心力衰竭（HR，3.32[95%CI，1.56-7.03]）；其他结果无统计学差异。使用β受体阻滞剂可显着改变COPD与死亡率之间的关系（Pint=0.018）。
结论：在亚洲房颤患者中，COPD与预后较差相关。在房颤和COPD患者中，β受体阻滞剂的使用与较低的死亡率相关.
■clinicaltrials.gov标识符：NCT04807049。
