Takeaway
- Patients with chronic obstructive pulmonary disease (COPD) have a 28% higher risk of developing atrial fibrillation; the risk was further increased in patients with frequent exacerbations and an enlarged left atrium.
- Elevated systemic inflammatory levels were positively related to risk for atrial fibrillation.
Why this matters
- Targeting underlying systemic inflammation in patients with COPD may prevent atrial fibrillation.
Study design
- This large prospective population-based study evaluated the incidence of atrial fibrillation in COPD subjects compared to subjects without COPD (n=10,943).
- Funding: Erasmus MC and Erasmus University Rotterdam; Netherlands Organisation for Scientific Research; others.
Key results
- 1369 participants had COPD.
- 131 participants with COPD and 673 without COPD developed atrial fibrillation.
- Atrial fibrillation incidence rate was 13.7 per 1000 person years in COPD and 7.5 per 1000 person years in participants without COPD.
- Risk of developing atrial fibrillation was significantly higher in participants with COPD vs those without COPD (aHR, 1.28; P=.018).
- Participants with COPD with frequent exacerbations had almost 2-fold higher risk for atrial fibrillation vs those without (aHR, 1.99; P<.001).
- Presence of COPD in participants with left atrial size ≥40 mm was associated with significant risk for atrial fibrillation (aHR, 1.77; P=.027).
- Participants with COPD with baseline systemic inflammatory levels above the median showed significantly increased atrial fibrillation risks (high-sensitivity C-reactive protein ≥1.83 mg/L: aHR 1.51; P=.005 and interleukin-6 ≥1.91 ng/L: aHR 2.49; P=.017).
Limitations
- Exact date of atrial fibrillation incidence was difficult to determine.
References
References
