Competitive interaction between chronic obstructive pulmonary disease and CHA2DS2-VASc score in predicting incident atrial fibrillation

Salvatore Corrao, Sofia Miceli, Giovanni Tripepi, Salvatore Corrao, Giorgio Sesti, Francesco Perticone, Angela Sciacqua, Maria Perticone

Risultato della ricerca: Article

2 Citazioni (Scopus)

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, and an emerging risk factor for atrial fibrillation (AF). CHADS2 and CHA2DS2-VASc scores are significantly associated with incident AF independently of other risk factors. The aim of this study was to demonstrate a possible interaction between COPD and CHA2DS2-VASc in predicting incident AF. Methods: This observational prospective cohort study included 4322 Caucasians with cardiovascular risk factors, stratified by CHA2DS2-VASc score (> 2 vs < 2) and presence/absence of COPD. To detect AF appearance, patients underwent, every 6 months, physical examination, standard 12‑lead electrocardiogram and routine laboratory tests. Results: COPD prevalence was significantly higher in patients with CHA2DS2-VASc ≥ 2 vs CHA2DS2-VASc < 2 category (13.3% vs 10.5%, P = 0.009). During the follow-up, 589 cases of AF were documented (3.8 events/100 patients-year). COPD+ showed a significantly higher incidence of AF vs COPD− patients (17.4 vs 8.4 events/100 patients-year, P < 0.0001). In Cox regression models both CHA2DS2-VASc score (HR = 4.70, 95% CI = 3.63–6.08) and COPD (HR = 2.04, 95% CI = 1.69–2.48) significantly predicted the incidence rate of AF; this was also confirmed introducing the two variables into the same Cox model. A significant competitive interaction between CHA2DS2-VASc and COPD was found in a Cox model in patients with CHA2DS2-VASc < 2 (HR = 8.45, 95% CI = 5.20–13.74) than in those with CHA2DS2-VASc ≥ 2. Conclusions: COPD is an independent and strong predictor of incident AF. The presence of COPD increases the HR for incident AF about five times in patients with CHA2DS2VASc score < 2, while the coexistence of a CHA2DS2Vasc score ≥ 2 minimizes the prognostic significance of COPD.
Lingua originaleEnglish
pagine (da-a)74-79
Numero di pagine6
RivistaINTERNATIONAL JOURNAL OF CARDIOLOGY
Volume255
Stato di pubblicazionePublished - 2018

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Atrial Fibrillation
Chronic Obstructive Pulmonary Disease
Proportional Hazards Models
Incidence
Physical Examination
Electrocardiography
Cohort Studies
Prospective Studies
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cita questo

Competitive interaction between chronic obstructive pulmonary disease and CHA2DS2-VASc score in predicting incident atrial fibrillation. / Corrao, Salvatore; Miceli, Sofia; Tripepi, Giovanni; Corrao, Salvatore; Sesti, Giorgio; Perticone, Francesco; Sciacqua, Angela; Perticone, Maria.

In: INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol. 255, 2018, pag. 74-79.

Risultato della ricerca: Article

Corrao, S, Miceli, S, Tripepi, G, Corrao, S, Sesti, G, Perticone, F, Sciacqua, A & Perticone, M 2018, 'Competitive interaction between chronic obstructive pulmonary disease and CHA2DS2-VASc score in predicting incident atrial fibrillation', INTERNATIONAL JOURNAL OF CARDIOLOGY, vol. 255, pagg. 74-79.
Corrao, Salvatore ; Miceli, Sofia ; Tripepi, Giovanni ; Corrao, Salvatore ; Sesti, Giorgio ; Perticone, Francesco ; Sciacqua, Angela ; Perticone, Maria. / Competitive interaction between chronic obstructive pulmonary disease and CHA2DS2-VASc score in predicting incident atrial fibrillation. In: INTERNATIONAL JOURNAL OF CARDIOLOGY. 2018 ; Vol. 255. pagg. 74-79.
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title = "Competitive interaction between chronic obstructive pulmonary disease and CHA2DS2-VASc score in predicting incident atrial fibrillation",
abstract = "Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, and an emerging risk factor for atrial fibrillation (AF). CHADS2 and CHA2DS2-VASc scores are significantly associated with incident AF independently of other risk factors. The aim of this study was to demonstrate a possible interaction between COPD and CHA2DS2-VASc in predicting incident AF. Methods: This observational prospective cohort study included 4322 Caucasians with cardiovascular risk factors, stratified by CHA2DS2-VASc score (> 2 vs < 2) and presence/absence of COPD. To detect AF appearance, patients underwent, every 6 months, physical examination, standard 12‑lead electrocardiogram and routine laboratory tests. Results: COPD prevalence was significantly higher in patients with CHA2DS2-VASc ≥ 2 vs CHA2DS2-VASc < 2 category (13.3{\%} vs 10.5{\%}, P = 0.009). During the follow-up, 589 cases of AF were documented (3.8 events/100 patients-year). COPD+ showed a significantly higher incidence of AF vs COPD− patients (17.4 vs 8.4 events/100 patients-year, P < 0.0001). In Cox regression models both CHA2DS2-VASc score (HR = 4.70, 95{\%} CI = 3.63–6.08) and COPD (HR = 2.04, 95{\%} CI = 1.69–2.48) significantly predicted the incidence rate of AF; this was also confirmed introducing the two variables into the same Cox model. A significant competitive interaction between CHA2DS2-VASc and COPD was found in a Cox model in patients with CHA2DS2-VASc < 2 (HR = 8.45, 95{\%} CI = 5.20–13.74) than in those with CHA2DS2-VASc ≥ 2. Conclusions: COPD is an independent and strong predictor of incident AF. The presence of COPD increases the HR for incident AF about five times in patients with CHA2DS2VASc score < 2, while the coexistence of a CHA2DS2Vasc score ≥ 2 minimizes the prognostic significance of COPD.",
author = "Salvatore Corrao and Sofia Miceli and Giovanni Tripepi and Salvatore Corrao and Giorgio Sesti and Francesco Perticone and Angela Sciacqua and Maria Perticone",
year = "2018",
language = "English",
volume = "255",
pages = "74--79",
journal = "INTERNATIONAL JOURNAL OF CARDIOLOGY",
issn = "0167-5273",

}

TY - JOUR

T1 - Competitive interaction between chronic obstructive pulmonary disease and CHA2DS2-VASc score in predicting incident atrial fibrillation

AU - Corrao, Salvatore

AU - Miceli, Sofia

AU - Tripepi, Giovanni

AU - Corrao, Salvatore

AU - Sesti, Giorgio

AU - Perticone, Francesco

AU - Sciacqua, Angela

AU - Perticone, Maria

PY - 2018

Y1 - 2018

N2 - Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, and an emerging risk factor for atrial fibrillation (AF). CHADS2 and CHA2DS2-VASc scores are significantly associated with incident AF independently of other risk factors. The aim of this study was to demonstrate a possible interaction between COPD and CHA2DS2-VASc in predicting incident AF. Methods: This observational prospective cohort study included 4322 Caucasians with cardiovascular risk factors, stratified by CHA2DS2-VASc score (> 2 vs < 2) and presence/absence of COPD. To detect AF appearance, patients underwent, every 6 months, physical examination, standard 12‑lead electrocardiogram and routine laboratory tests. Results: COPD prevalence was significantly higher in patients with CHA2DS2-VASc ≥ 2 vs CHA2DS2-VASc < 2 category (13.3% vs 10.5%, P = 0.009). During the follow-up, 589 cases of AF were documented (3.8 events/100 patients-year). COPD+ showed a significantly higher incidence of AF vs COPD− patients (17.4 vs 8.4 events/100 patients-year, P < 0.0001). In Cox regression models both CHA2DS2-VASc score (HR = 4.70, 95% CI = 3.63–6.08) and COPD (HR = 2.04, 95% CI = 1.69–2.48) significantly predicted the incidence rate of AF; this was also confirmed introducing the two variables into the same Cox model. A significant competitive interaction between CHA2DS2-VASc and COPD was found in a Cox model in patients with CHA2DS2-VASc < 2 (HR = 8.45, 95% CI = 5.20–13.74) than in those with CHA2DS2-VASc ≥ 2. Conclusions: COPD is an independent and strong predictor of incident AF. The presence of COPD increases the HR for incident AF about five times in patients with CHA2DS2VASc score < 2, while the coexistence of a CHA2DS2Vasc score ≥ 2 minimizes the prognostic significance of COPD.

AB - Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, and an emerging risk factor for atrial fibrillation (AF). CHADS2 and CHA2DS2-VASc scores are significantly associated with incident AF independently of other risk factors. The aim of this study was to demonstrate a possible interaction between COPD and CHA2DS2-VASc in predicting incident AF. Methods: This observational prospective cohort study included 4322 Caucasians with cardiovascular risk factors, stratified by CHA2DS2-VASc score (> 2 vs < 2) and presence/absence of COPD. To detect AF appearance, patients underwent, every 6 months, physical examination, standard 12‑lead electrocardiogram and routine laboratory tests. Results: COPD prevalence was significantly higher in patients with CHA2DS2-VASc ≥ 2 vs CHA2DS2-VASc < 2 category (13.3% vs 10.5%, P = 0.009). During the follow-up, 589 cases of AF were documented (3.8 events/100 patients-year). COPD+ showed a significantly higher incidence of AF vs COPD− patients (17.4 vs 8.4 events/100 patients-year, P < 0.0001). In Cox regression models both CHA2DS2-VASc score (HR = 4.70, 95% CI = 3.63–6.08) and COPD (HR = 2.04, 95% CI = 1.69–2.48) significantly predicted the incidence rate of AF; this was also confirmed introducing the two variables into the same Cox model. A significant competitive interaction between CHA2DS2-VASc and COPD was found in a Cox model in patients with CHA2DS2-VASc < 2 (HR = 8.45, 95% CI = 5.20–13.74) than in those with CHA2DS2-VASc ≥ 2. Conclusions: COPD is an independent and strong predictor of incident AF. The presence of COPD increases the HR for incident AF about five times in patients with CHA2DS2VASc score < 2, while the coexistence of a CHA2DS2Vasc score ≥ 2 minimizes the prognostic significance of COPD.

UR - http://hdl.handle.net/10447/320383

M3 - Article

VL - 255

SP - 74

EP - 79

JO - INTERNATIONAL JOURNAL OF CARDIOLOGY

JF - INTERNATIONAL JOURNAL OF CARDIOLOGY

SN - 0167-5273

ER -