Major adverse cardiovascular events in non-valvular atrial fibrillation with chronic obstructive pulmonary disease: the ARAPACIS study

Chronic obstructive pulmonary disease (COPD) increases the risk of mortality in non-valvular atrial fibrillation (NVAF) patients. Data on the relationship of COPD to major cardiovascular events (MACE) in AF have not been defined. The aim of the study is to assess the predictive value of COPD on inci...

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Bibliographic Details
Published in:Internal and emergency medicine 2018-08, Vol.13 (5), p.651-660
Main Authors: Raparelli, Valeria, Pastori, Daniele, Pignataro, Serena Francesca, Vestri, Anna Rita, Pignatelli, Pasquale, Cangemi, Roberto, Proietti, Marco, Davì, Giovanni, Hiatt, William Robert, Lip, Gregory Yoke Hong, Corazza, Gino Roberto, Perticone, Francesco, Violi, Francesco, Basili, Stefania
Format: Article
Language:English
Subjects:
Aged
Ankle
Atrial Fibrillation - complications
Cardiac arrhythmia
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - mortality
Cause of Death
Chronic obstructive pulmonary disease
Death
Endpoint Determination
Female
Fibrillation
Follow-Up Studies
Geriatrics
Health risk assessment
Health risks
Humans
Im - Original
Incidence
Internal Medicine
Italy - epidemiology
Lung diseases
Male
Medicine
Medicine & Public Health
Mortality
Obstructive lung disease
Older people
Predictive Value of Tests
Prevalence
Prospective Studies
Pulmonary Disease, Chronic Obstructive - complications
Registries
Risk Factors
Stroke
Thromboembolism
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Summary:Chronic obstructive pulmonary disease (COPD) increases the risk of mortality in non-valvular atrial fibrillation (NVAF) patients. Data on the relationship of COPD to major cardiovascular events (MACE) in AF have not been defined. The aim of the study is to assess the predictive value of COPD on incident MACE in NVAF patients over a 3-year follow-up. In the Atrial Fibrillation Registry for Ankle-Brachial Index Prevalence Assessment-Collaborative Italian Study (ARAPACIS) cohort, we evaluate the impact of COPD on the following clinical endpoints: MACE (including vascular death, fatal/non-fatal MI and stroke/TIA), cardiovascular (CV) death and all-cause mortality. Among 2027 NVAF patients, patients with COPD (9%) are more commonly male, elderly and at higher thromboembolic risk. During a median 36.0 months follow-up, 186 patients experienced MACE: vascular death ( n  = 72), MI ( n  = 57), stroke/TIA ( n  = 57). All major outcomes (including stroke/TIA, MI, vascular death, and all-cause death) are centrally adjudicated. Kaplan–Meier curves show that NVAF patients with COPD are at higher risk for MACE ( p  
ISSN:1828-0447
1970-9366
DOI:10.1007/s11739-018-1835-9