Key result
COPD is linked to ~72% higher AF risk in a bidirectional relationship that increases mortality.
Why the study?
The study aimed to comprehensively evaluate the bidirectional epidemiological association between COPD and AF, as well as their combined impact on prognosis.
Is there a bidirectional association between COPD and AF, and does their coexistence impact mortality?
Meta-Analysis
Is there a bidirectional association between COPD and AF, and does their coexistence impact mortality?
There is a bidirectional association between COPD and AF, and their coexistence is associated with increased short- and long-term mortality.
Objective: This study aims to comprehensively evaluate the bidirectional epidemiological association between chronic obstructive pulmonary disease (COPD) and atrial fibrillation (AF), as well as their combined impact on prognosis, providing evidence to inform the clinical management of comorbidities. Methods: In accordance with PRISMA guidelines, a systematic literature search was conducted in PubMed, EMBASE, and the Cochrane Library from inception through June 2025, focusing on cohort and case-control studies. Study quality was assessed using the Newcastle-Ottawa Scale, and odds ratios (OR) were pooled using either random-effects or fixed-effects models to quantify the bidirectional risk between COPD and AF and their prognostic effects. Results: A total of 48 unique publications were included. The findings showed that AF was associated with a higher risk of COPD (OR = 1.56, 95% CI 1.06-2.29), and COPD was similarly associated with a higher risk of AF (OR = 1.72, 95% CI 1.42-2.09). Additionally, AF in COPD patients was associated with increased short-term (OR = 1.76) and long-term (OR = 1.27) mortality risks, while COPD in AF patients was also associated with increased mortality risks (short-term OR = 1.54, long-term OR = 1.68). Conclusion: COPD and AF showed a bidirectional observational association, and their coexistence was associated with increased mortality risk. Given the observational nature of the included studies and substantial heterogeneity, these findings should be interpreted as associations rather than causal effects. These findings highlight the need for integrated and individualized management strategies in patients with comorbid COPD and AF. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251069785.
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Wang et al. (2026) conducted a meta-analysis in Chronic Obstructive Pulmonary Disease (COPD) and Atrial Fibrillation (AF). Chronic obstructive pulmonary disease (COPD) vs. Patients without COPD was evaluated on Risk of incident atrial fibrillation (AF) (OR 1.72, 95% CI 1.42-2.09, p=0.000). COPD and AF demonstrated a bidirectional observational association, with COPD increasing the risk of AF (OR 1.72) and AF increasing the risk of COPD (OR 1.56), while their coexistence increased mortality.
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