{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:25:14Z","timestamp":1792686314262,"version":"4.5.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,4,2]]},"abstract":"\n Background<\/jats:title>\n Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of adverse events in patients with atrial fibrillation (AF); however, few data are available on this topic in Asian populations.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Prospective observational study conducted on patients with AF enrolled in the Asia\u2010Pacific Heart Rhythm Society (APHRS) AF Registry. The diagnosis of COPD was based on data reported in the case report form by the investigators. Cox\u2010regression models were used to assess the 1\u2010year risk of a primary composite outcome of all\u2010cause death, thromboembolic events, acute coronary syndrome, and heart failure. Analysis on single outcomes and cardiovascular death was also performed. Interaction analysis was used to assess the risk of composite outcome and all\u2010cause death in different subgroups. The study included 4094 patients with AF (mean\u00b1SD age 68.5\u00b112\u2009years,\u00a034.6% female), of whom 112 (2.7%) had COPD. Patients with COPD showed a higher incidence of the primary composite outcome (25.1% versus 6.3%,\n P<\/jats:italic>\n <0.001), all\u2010cause death (14.9% versus 2.6%,\n P<\/jats:italic>\n <0.001), cardiovascular death (2.0% versus 0.6%,\n P<\/jats:italic>\n <0.001), and heart failure (8.3% versus 6.0%,\n P<\/jats:italic>\n <0.001). On multiple Cox\u2010regression analysis, COPD was associated with a higher risk of the primary composite outcome (hazard ratio [HR], 3.17 [95% CI, 2.05\u20134.90]), all\u2010cause death (HR, 3.59 [95% CI, 2.04\u20136.30]), and heart failure (HR, 3.32 [95% CI, 1.56\u20137.03]); no statistically significant differences were found for other outcomes. The association between COPD and mortality was significantly modified by the use of beta blockers (\n P<\/jats:italic>\n int<\/jats:sub>\n =0.018).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In Asian patients with AF, COPD is associated with worse prognosis. In patients with AF and COPD, the use of beta blockers was associated with a lower mortality.<\/jats:p>\n <\/jats:sec>\n \n Registration Information<\/jats:title>\n \n clinicaltrials.gov<\/jats:ext-link>\n Identifier:\n NCT04807049<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.123.032785","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T08:01:17Z","timestamp":1711526477000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Risk of Death and Cardiovascular Events in Asian Patients With Atrial Fibrillation and Chronic Obstructive Pulmonary Disease: A Report From the Prospective APHRS Registry"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2895-6234","authenticated-orcid":false,"given":"Tommaso","family":"Bucci","sequence":"first","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UK"},{"name":"Department of General and Specialized Surgery Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-8942","authenticated-orcid":false,"given":"Giulio Francesco","family":"Romiti","sequence":"additional","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UK"},{"name":"Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0594-8576","authenticated-orcid":false,"given":"Alena","family":"Shantsila","sequence":"additional","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wee\u2010Siong","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Heart Centre Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9630-0467","authenticated-orcid":false,"given":"Hyung\u2010Wook","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Chonnam National University Hospital Gwangju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-8973","authenticated-orcid":false,"given":"Wataru","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Nippon Medical School Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9460-4435","authenticated-orcid":false,"given":"Bernadette","family":"Corica","sequence":"additional","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UK"},{"name":"Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-2478","authenticated-orcid":false,"given":"Marco","family":"Proietti","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health University of Milan Milan Italy"},{"name":"Division of Subacute Care IRCCS Istituti Clinici Scientifici Maugeri Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-7808","authenticated-orcid":false,"given":"Hung\u2010Fat","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Clinical Medicine; Queen Mary Hospital The University of Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze\u2010Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, and Cardiovascular Research Center National Yang Ming Chiao Tung University Taipei Taiwan"},{"name":"Division of Cardiology, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Frost","sequence":"additional","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. 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