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Chronic Obstructive Pulmonary Disease (COPD) and the Development of Atrial Fibrillation

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A7513 - Chronic Obstructive Pulmonary Disease (COPD) and the Development of Atrial Fibrillation
Author Block: L. Lahousse1, M. Grymonprez2, V. Vakaet2, M. Kavousi3, B. Stricker3, M. Ikram3, J. Heeringa3, F. Oscar3, G. G. Brusselle2; 1Bioanalysis, Ghent University, Ghent, Belgium, 2Ghent University Hospital, Ghent, Belgium, 3Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
Rationale: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, whereas chronic obstructive pulmonary disease (COPD) is one of the most common respiratory diseases worldwide. Because AF frequently leads to morbidity and mortality if untreated, examining a potential association between AF and COPD is clinically relevant.
Objective: This study aimed to investigate whether COPD increases the risk of developing AF and which subset of patients is at the highest risk of incident AF.
Methods and Results: The Rotterdam Study is a large, population-based cohort study with long-term follow-up. Time dependent Cox proportional hazard models were constructed to study the effect of COPD on incident AF, adjusted for age, sex and pack years of cigarette smoking. 1369 of 10 943 included subjects had COPD. During 99 242 person years of follow-up, 804 subjects developed AF. The incidence rate of AF was 14 per 1000 person years in COPD and 8 per 1 000 person years in subjects without COPD. The adjusted hazard ratio (HR) for COPD subjects to develop AF as compared to subjects without COPD was 1.28 [95% CI 1.04, 1.57]. COPD subjects with frequent exacerbations had a twofold increased risk to develop AF as compared to subjects without COPD (HR 1.99 [1.42, 2.79]). Additionally, the incident AF risk in subjects with COPD was driven by COPD subjects with a left atrial size equal or above the median of 40 mm (HR 2.02 [1.32, 3.10]).
Conclusion: COPD subjects had a 28% increased risk of developing AF. The risk further increased in COPD subjects with frequent exacerbations and with an enlarged left atrium.
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