COPD increases cardiac mortality in patients presenting with ventricular tachyarrhythmias and aborted cardiac arrest
Objectives - The study sought to assess the prognostic impact of COPD in patients presenting with ventricular tachyarrhythmias and sudden cardiac arrest (SCA) on admission. - Background - Data regarding the outcome of patients with COPD presenting with ventricular tachyarrhythmias and SCA is limited...
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| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
24 October 2018
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| In: |
Respiratory medicine
Year: 2018, Volume: 145, Pages: 153-160 |
| ISSN: | 1532-3064 |
| DOI: | 10.1016/j.rmed.2018.10.019 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1016/j.rmed.2018.10.019 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0954611118303251 
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| Author Notes: | Jonas Rusnak, Michael Behnes, Tobias Schupp, Linda Reiser, Armin Bollow, Gabriel Taton, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Jorge Hoppner, Kathrin Weidner, Ibrahim El-Battrawy, Kambis Mashayekhi, Christel Weiß, Martin Borggrefe, Ibrahim Akin |
| Summary: | Objectives - The study sought to assess the prognostic impact of COPD in patients presenting with ventricular tachyarrhythmias and sudden cardiac arrest (SCA) on admission. - Background - Data regarding the outcome of patients with COPD presenting with ventricular tachyarrhythmias and SCA is limited. - Methods - A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT), fibrillation (VF) and SCA from 2002 to 2016. Patients with COPD were compared to patients without COPD applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint defined as long-term all-cause mortality at 2 years. Secondary endpoints were all-cause mortality at index, at 30 days and after discharge, cardiac death at 24h, rehospitalization related to cardiac causes and the composite endpoint of cardiac death at 24h, recurrences of ventricular tachyarrhythmias and appropriate ICD therapies at 2 years. - Results - In 2813 unmatched high-risk patients with ventricular tachyarrhythmias and SCA, COPD was present in 9%. VF was less common in COPD (28% versus 39%; p= 0.001). Multivariable Cox regression models revealed that COPD was associated with the primary endpoint of long-term all-cause mortality (HR=1.245; 95% CI 1.001-1.549; p = 0.001), which was also proven after propensity score matching (log rank p=0.001). The secondary endpoints of all-cause mortality at index, at 30 days, after discharge, cardiac death at 24h, as well as the composite endpoint of cardiac death at 24h, recurrences of ventricular tachyarrhythmias and appropriate ICD therapies were higher in COPD (p<0.033). - Conclusion - In high-risk patients presenting with ventricular tachyarrhythmias and SCA, COPD was associated with higher long-term all-cause mortality, cardiac death at 24h and higher rates of the composite endpoint of cardiac death at 24h, recurrences of ventricular tachyarrhythmias and appropriate ICD therapies at 2 years. |
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| Item Description: | Gesehen am 06.05.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1532-3064 |
| DOI: | 10.1016/j.rmed.2018.10.019 |