Abstract

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 < 0.001), CV death (p < 0.001) and all-cause death (p < 0.001). On Cox proportional hazard analysis, COPD is an independent predictor of MACE (Hazard ratio [HR] 1.77, 95% Confidence Intervals [CI] 1.20–2.61; p = 0.004), CV death (HR 2.73, 95% CI 1.76–4.23; p < 0.0001) and all-cause death (HR 2.16, 95% CI 1.48–3.16; p < 0.0001). COPD is an independent predictor of MACE, CV death and all-cause death during a long-term follow-up of NVAF patients.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalInternal and Emergency Medicine
DOIs
Publication statusAccepted/In press - Mar 26 2018

Fingerprint

Ankle Brachial Index
Atrial Fibrillation
Chronic Obstructive Pulmonary Disease
Registries
Cause of Death
Blood Vessels
Confidence Intervals
Stroke
Mortality
Cohort Studies
Myocardial Infarction

Keywords

  • Atrial fibrillation
  • Cardiovascular mortality
  • Chronic obstructive pulmonary disease
  • Major cardiovascular events

ASJC Scopus subject areas

  • Internal Medicine
  • Emergency Medicine

Cite this

@article{7304466ec5414a77923829fdbbd78e18,
title = "Major adverse cardiovascular events in non-valvular atrial fibrillation with chronic obstructive pulmonary disease: the ARAPACIS study",
abstract = "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 < 0.001), CV death (p < 0.001) and all-cause death (p < 0.001). On Cox proportional hazard analysis, COPD is an independent predictor of MACE (Hazard ratio [HR] 1.77, 95{\%} Confidence Intervals [CI] 1.20–2.61; p = 0.004), CV death (HR 2.73, 95{\%} CI 1.76–4.23; p < 0.0001) and all-cause death (HR 2.16, 95{\%} CI 1.48–3.16; p < 0.0001). COPD is an independent predictor of MACE, CV death and all-cause death during a long-term follow-up of NVAF patients.",
keywords = "Atrial fibrillation, Cardiovascular mortality, Chronic obstructive pulmonary disease, Major cardiovascular events",
author = "{Arapacis Study Collaborators} and Corazza, {Gino Roberto} and Pasini, {A. F.} and V. Spagnuolo and M. Barbagallo and A. Pinto and V. Fazio and {de Luca}, N. and D. Caputo and M. Cilli and F. Pastore and S. Messina and V. Spagnuolo and G. Battaglia and E. Angelucci and M. Bertolotti and C. Mussi and {de Luca}, E. and S. Romano and A. Castagna and D. Spinelli and E. Miceli and G. Schinco and L. Sansone and Serra, {M. G.} and S. Longo and A. Belfiore and M. Salvetti and C. Bracco and Martino, {G. P.} and A. Sacco and F. Russo and C. Ferri and F. Mazzei and M. Porta and M. Pala and C. Moroni and M. Moia and S. Braham and M. Rossi and M. Pesce and A. Gentile and S. Negri and G. Porciello and Sacchetti, {M. L.} and Bianchi, {P. I.} and C. Bracco and Carrabba, {M. D.} and Colombo, {B. M.} and A. Forgione and A. Marchese and Marra, {A. M.} and M. Pinna and Vecchio, {C. R.}",
year = "2018",
month = "3",
day = "26",
doi = "10.1007/s11739-018-1835-9",
language = "English",
pages = "1--10",
journal = "Internal and Emergency Medicine",
issn = "1828-0447",
publisher = "Springer-Verlag Italia s.r.l.",

}

TY - JOUR

T1 - Major adverse cardiovascular events in non-valvular atrial fibrillation with chronic obstructive pulmonary disease

T2 - the ARAPACIS study

AU - Arapacis Study Collaborators

AU - Corazza, Gino Roberto

AU - Pasini, A. F.

AU - Spagnuolo, V.

AU - Barbagallo, M.

AU - Pinto, A.

AU - Fazio, V.

AU - de Luca, N.

AU - Caputo, D.

AU - Cilli, M.

AU - Pastore, F.

AU - Messina, S.

AU - Spagnuolo, V.

AU - Battaglia, G.

AU - Angelucci, E.

AU - Bertolotti, M.

AU - Mussi, C.

AU - de Luca, E.

AU - Romano, S.

AU - Castagna, A.

AU - Spinelli, D.

AU - Miceli, E.

AU - Schinco, G.

AU - Sansone, L.

AU - Serra, M. G.

AU - Longo, S.

AU - Belfiore, A.

AU - Salvetti, M.

AU - Bracco, C.

AU - Martino, G. P.

AU - Sacco, A.

AU - Russo, F.

AU - Ferri, C.

AU - Mazzei, F.

AU - Porta, M.

AU - Pala, M.

AU - Moroni, C.

AU - Moia, M.

AU - Braham, S.

AU - Rossi, M.

AU - Pesce, M.

AU - Gentile, A.

AU - Negri, S.

AU - Porciello, G.

AU - Sacchetti, M. L.

AU - Bianchi, P. I.

AU - Bracco, C.

AU - Carrabba, M. D.

AU - Colombo, B. M.

AU - Forgione, A.

AU - Marchese, A.

AU - Marra, A. M.

AU - Pinna, M.

AU - Vecchio, C. R.

PY - 2018/3/26

Y1 - 2018/3/26

N2 - 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 < 0.001), CV death (p < 0.001) and all-cause death (p < 0.001). On Cox proportional hazard analysis, COPD is an independent predictor of MACE (Hazard ratio [HR] 1.77, 95% Confidence Intervals [CI] 1.20–2.61; p = 0.004), CV death (HR 2.73, 95% CI 1.76–4.23; p < 0.0001) and all-cause death (HR 2.16, 95% CI 1.48–3.16; p < 0.0001). COPD is an independent predictor of MACE, CV death and all-cause death during a long-term follow-up of NVAF patients.

AB - 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 < 0.001), CV death (p < 0.001) and all-cause death (p < 0.001). On Cox proportional hazard analysis, COPD is an independent predictor of MACE (Hazard ratio [HR] 1.77, 95% Confidence Intervals [CI] 1.20–2.61; p = 0.004), CV death (HR 2.73, 95% CI 1.76–4.23; p < 0.0001) and all-cause death (HR 2.16, 95% CI 1.48–3.16; p < 0.0001). COPD is an independent predictor of MACE, CV death and all-cause death during a long-term follow-up of NVAF patients.

KW - Atrial fibrillation

KW - Cardiovascular mortality

KW - Chronic obstructive pulmonary disease

KW - Major cardiovascular events

UR - http://www.scopus.com/inward/record.url?scp=85044454698&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044454698&partnerID=8YFLogxK

U2 - 10.1007/s11739-018-1835-9

DO - 10.1007/s11739-018-1835-9

M3 - Article

AN - SCOPUS:85044454698

SP - 1

EP - 10

JO - Internal and Emergency Medicine

JF - Internal and Emergency Medicine

SN - 1828-0447

ER -