Romiti, G. F. et al. (2021) Prevalence, management and impact of chronic obstructive pulmonary disease in atrial fibrillation: a systematic review and meta-analysis of 4,200,000 patients. European Heart Journal, 42(35), pp. 3541-3554. (doi: 10.1093/eurheartj/ehab453) (PMID:34333599)
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Abstract
Aim: Prevalence of chronic obstructive pulmonary disease (COPD) in atrial fibrillation (AF) patients is unclear, and its association with adverse outcomes is often overlooked. Our aim was to estimate the prevalence of COPD, its impact on clinical management and outcomes in patients with AF, and the impact of beta-blockers (BBs) on outcomes in patients with COPD. Methods and results: A systematic review and meta-analysis was conducted according to international guidelines. All studies reporting the prevalence of COPD in AF patients were included. Data on comorbidities, BBs and oral anticoagulant prescription, and outcomes (all-cause death, cardiovascular (CV) death, ischaemic stroke, major bleeding) were compared according to COPD and BB status. Among 46 studies, pooled prevalence of COPD was 13% [95% confidence intervals (CI) 10–16%, 95% prediction interval 2–47%]. COPD was associated with higher prevalence of comorbidities, higher CHA2DS2-VASc score and lower BB prescription [odds ratio (OR) 0.77, 95% CI 0.61–0.98]. COPD was associated with higher risk of all-cause death (OR 2.22, 95% CI 1.93–2.55), CV death (OR 1.84, 95% CI 1.39–2.43), and major bleeding (OR 1.45, 95% CI 1.17–1.80); no significant differences in outcomes were observed according to BB use in AF patients with COPD. Conclusion: COPD is common in AF, being found in 13% of patients, and is associated with increased burden of comorbidities, differential management, and worse outcomes, with more than a two-fold higher risk of all-cause death and increased risk of CV death and major bleeding. Therapy with BBs does not increase the risk of adverse outcomes in patients with AF and COPD.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Jani, Dr Bhautesh and Mair, Professor Frances |
| Authors: | Romiti, G. F., Corica, B., Pipitone, E., Vitolo, M., Raparelli, V., Basili, S., Boriani, G., Harari, S., Lip, G. Y. H., Proietti, M., the AF-COMET International Collaborative Group, ., and , |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care |
| Journal Name: | European Heart Journal |
| Publisher: | Oxford University Press |
| ISSN: | 0195-668X |
| ISSN (Online): | 1522-9645 |
| Published Online: | 01 August 2021 |
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