Chronic obstructive pulmonary disease in patients with atrial fibrillation: Insights from the ARISTOTLE trial

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Fältnamn	Indikatorer	Metadata
000		04401naa a2200457 4500
001		oai:DiVA.org:uu-272042
003		SwePub
008		160111s2016 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2720422 URI
024	7	a https://doi.org/10.1016/j.ijcard.2015.09.0622 DOI
040		a (SwePub)uu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Durheim, Michael T.u Duke Clin Res Inst, Durham, NC USA.;Duke Univ, Med Ctr, Div Pulm Allergy & Crit Care Med, Durham, NC USA.4 aut
245	1 0	a Chronic obstructive pulmonary disease in patients with atrial fibrillation :b Insights from the ARISTOTLE trial
264	1	b Elsevier BV,c 2016
338		a print2 rdacarrier
520		a Background: Comorbid chronic obstructive pulmonary disease (COPD) is associated with poor outcomes among patients with cardiovascular disease. The risks of stroke and mortality associated with COPD among patients with atrial fibrillation are not well understood. Methods: We analyzed patients from ARISTOTLE, a randomized trial of 18,201 patients with atrial fibrillation comparing the effects of apixaban versus warfarin on the risk of stroke or systemic embolism. Using Cox proportional hazards models, we assessed the associations between comorbid COPD and risk of stroke or systemic embolism and of mortality, adjusting for treatment allocation, smoking history and other risk factors. Results: COPD was present in 1950 (10.8%) of 18,134 patients with data on pulmonary disease history. After multivariable adjustment, COPD was not associated with risk of stroke or systemic embolism (adjusted HR 0.85 [95% CI 0.60, 1.21], p = 0.356). However, COPD was associated with a higher risk of all-cause mortality (adjusted HR 1.60 [95% CI 1.36, 1.88], p < 0.001) and both cardiovascular and non-cardiovascular mortality. The benefit of apixaban over warfarin on stroke or systemic embolism was consistent among patients with and without COPD (HR 0.92 [95% CI 0.52, 1.63] versus 0.78 [95% CI 0.65, 0.95], interaction p = 0.617). Conclusions: COPD was independently associated with increased risk of cardiovascular and non-cardiovascular mortality among patients with atrial fibrillation, but was not associated with risk of stroke or systemic embolism. The effect of apixaban on stroke or systemic embolism in COPD patients was consistent with its effect in the overall trial population.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653		a COPD
653		a Atrial fibrillation
653		a Anticoagulation
653		a Mortality
653		a Stroke
700	1	a Cyr, Derek D.u Duke Clin Res Inst, Durham, NC USA.4 aut
700	1	a Lopes, Renato D.u Duke Clin Res Inst, Durham, NC USA.;Duke Univ, Med Ctr, Div Cardiol, Durham, NC 27710 USA.4 aut
700	1	a Thomas, Laine E.u Duke Clin Res Inst, Durham, NC USA.4 aut
700	1	a Tsuang, Wayne M.u Cleveland Clin, Dept Pulm Med, Cleveland, OH 44106 USA.4 aut
700	1	a Gersh, Bernard J.u Coll Med, Mayo Clin, Div Cardiovasc Dis, Rochester, MN USA.4 aut
700	1	a Held, Claesu Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)clahe947
700	1	a Wallentin, Larsu Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)larswall
700	1	a Granger, Christopher B.u Duke Clin Res Inst, Durham, NC USA.;Duke Univ, Med Ctr, Div Cardiol, Durham, NC 27710 USA.4 aut
700	1	a Palmer, Scott M.u Duke Clin Res Inst, Durham, NC USA.;Duke Univ, Med Ctr, Div Pulm Allergy & Crit Care Med, Durham, NC USA.4 aut
700	1	a Al-Khatib, Sana M.u Duke Clin Res Inst, Durham, NC USA.;Duke Univ, Med Ctr, Div Cardiol, Durham, NC 27710 USA.4 aut
710	2	a Duke Clin Res Inst, Durham, NC USA.;Duke Univ, Med Ctr, Div Pulm Allergy & Crit Care Med, Durham, NC USA.b Duke Clin Res Inst, Durham, NC USA.4 org
773	0	t International Journal of Cardiologyd : Elsevier BVg 202, s. 589-594q 202<589-594x 0167-5273x 1874-1754
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-272042
856	4 8	u https://doi.org/10.1016/j.ijcard.2015.09.062

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Av författaren/redakt...: Durheim, Michael ...; Cyr, Derek D.; Lopes, Renato D.; Thomas, Laine E.; Tsuang, Wayne M.; Gersh, Bernard J ...; visa fler...; Held, Claes; Wallentin, Lars; Granger, Christo ...; Palmer, Scott M.; Al-Khatib, Sana ...; visa färre...

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Av lärosätet: Uppsala universitet

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