In patients with atrial fibrillation, comorbid COPD was associated with a significantly increased risk of AF progression (OR 1.90; 95% CI 1.34-2.68; p=0.0003).
Meta-Analysis (n=10,761)
Does the presence of COPD increase the risk of AF progression and recurrence in patients with atrial fibrillation?
COPD is an independent risk factor for AF progression and recurrence, indicating a worse prognosis for AF patients with comorbid COPD.
Odds Ratio: 1.9 (95% CI 1.34–2.68)
p-value: p=0.0003
// Xiaoying Chen 1, * , Meiling Lin 1, 2, * and Wei Wang 1 1 Department of Cardiology, The Second Affiliate Hospital of Shantou University Medical College, Guangdong, 515000, China 2 Department of Cardiology, The First Affiliate Hospital of Shantou University Medical College, Guangdong, 515000, China * These authors contributed equally to this work Correspondence to: Wei Wang, email: stwangwei@126.com Keywords: COPD, atrial fibrillation, progression, recurrence, meta-analysis Received: July 28, 2017 Accepted: September 22, 2017 Published: October 26, 2017 ABSTRACT Aim: Chronic Obstructive Pulmonary Disease (COPD) and atrial fibrillation (AF) share pathophysiological links, as supported by the high prevalence of AF within COPD patients. AF progression and recurrence can increase the risks of mortality, morbidity and adverse cardiovascular events. The present systematic review and meta-analysis aims to assess the risk for AF progression and recurrence for COPD patients, to further demonstrate the risk of COPD in AF patients. Methods and Results: A systematic review was conducted in MEDLINE / PubMed and Cochrane Library and Embase, Web of science. Prospective studies including AF patients with COPD were screened and included if matching inclusion and exclusion criteria. 7 studies were included, adding up to 10761 AF patients (1556 with AF and COPD, 9205 without COPD). Mean age from each study ranged from 51 to 81 years, and 57.2% were male. Hypertension accounted for 75.5% of the population, and 20.7% had the comorbidity of diabetes mellitus. The pool analysis showed that COPD could promote AF progression (OR = 1.90; 95% CI, 1.34–2.68, I 2 = 77%, p = 0.0003). For subgroup analysis, we found that COPD could increase the risk of AF recurrence (OR = 2.35; 95% CI, 1.86–2.97, I 2 = 0%, p = 0.39). Besides, in the younger group, at the median age of 64, COPD was still a risk factor for AF progression (OR = 2.22; 95% CI, 1.80–2.74, I 2 = 0%, p = 0.69). Conclusions: COPD is an independent risk for AF progression and recurrence, COPD patients with AF carry a worse prognosis than those in sinus rhythm (SR).
Chen et al. (2017) conducted a meta-analysis in Atrial fibrillation (n=10,761). Chronic Obstructive Pulmonary Disease (COPD) vs. Without COPD was evaluated on Atrial fibrillation progression (OR 1.90, 95% CI 1.34-2.68, p=0.0003). In patients with atrial fibrillation, comorbid COPD was associated with a significantly increased risk of AF progression (OR 1.90; 95% CI 1.34-2.68; p=0.0003).