Chronic obstructive pulmonary disease (COPD) is common among atrial fibrillation (AFib) patients and associated with worse clinical outcomes, according to new data published in the European Heart Journal.
"Despite the postulated association between COPD and AF, few studies have comprehensively analyzed the clinical relationships between these two conditions, especially concerning the risks of adverse outcomes and the implications for beta-blocker (BB) use," wrote lead author Giulio Francesco Romiti, with the department of translational and precision medicine at the University of Rome, and colleagues. "Indeed, experts have clearly demanded better evidence on the relationship between COPD and AFib."
Romiti et al. performed a systematic review and meta-analysis of 4,232,784 AFib patients from 46 different studies. Overall, the pooled prevalence of COPD was as high as 13% in AFib patients, with a high grade of heterogeneity among the included studies.
COPD was associated with a higher incidence of comorbidities and higher CHA2DS2 – VASc score. The authors found no meaningful differences in outcomes according to BB use in AFib patients who had COPD.
Patients with AFib and COPD were more likely to have a history of diabetes mellitus, coronary heart disease, chronic heart failure or stroke than those without COPD. They were also less likely to receive a BB, but no significant differences were seen in oral anticoagulant prescription rates.
Fourteen studies included in the meta-analysis focused on associations between outcomes and COPD diagnosis. Patients with COPD showed an increased risk for all-cause death, cardiovascular death and major bleeding events. The authors also saw a nonsignificant trend that suggested a higher risk of stroke.
“In view of these findings, our study underlines the importance of a systematic assessment of respiratory function in AFib patients, as well as the application of an integrated care approach to manage these patients," the group wrote.
Read the full study here.