COPD Linked To Increased Mortality, Especially From Cardiovascular Disease, In Patients With Atrial Fibrillation, But Not Stroke

Heart and Lungs
COPD is associated with greater mortality, but not stroke, among patients with atrial fibrillation. Photo Courtesy of Shutterstock

In what must be the very epitome of ‘good news, bad news’, researchers from Duke University and the Mayo Clinic have concluded that chronic obstructive pulmonary disease (COPD), is associated with a higher incidence of death, particularly from heart failure, but not with stroke.

The researchers examined data from a large randomized study of 18,206 patients suffering from an irregularly beating heart, known as atrial fibrillation, who were given one of two anticoagulants to manage their risk of developing a stroke or systemic embolism (strokes are a subset of embolisms, which occur when a clot travels from the heart to another part of the body and blocks blood flow; strokes occur in the brain). They then narrowed in on the 1,950 patients who had COPD, a degenerative, progressive weakening of the lungs’ ability to process air, often caused by smoking or air pollutants.

After adjusting for factors like a patient’s age, gender, and smoking history, they found that COPD wasn’t directly linked to stroke or embolism, but that it was associated with a 54 percent chance of increased mortality in general. As the authors note, COPD does place a greater burden on the heart, and their results bolster the overall perception that conditions like coronary artery disease and COPD are inevitably tied to one another. But it’s been harder to determine a clear relationship between COPD and stroke. COPD may still indirectly influence stroke risk because of its connection to cardiovascular disease, which is in turn has been linked to stroke, the authors note.

As things stand, COPD is the third leading cause of death in America, according to the National Heart, Lung, and Blood Institute. And being able to know what accompanying risks and health conditions can arise in the presence of COPD is invaluable information. Similarly, the authors were pleased to know that the medications the patients were given did not interact poorly with COPD. “The presence of COPD doesn't need to affect provider's choice of an anticoagulant," lead author Dr. Michael Durheim of Duke said in a press release.

Whether it’s stroke, COPD, or heart issues though, we do know that these ailments are all closely linked to or aggravated by risk factors like smoking and sedentary behavior. So no matter how you look at it, it seems that what’s good for the goose will no doubt be good for the gander, at least when it comes to healthy lifestyle choices.

Source: Durheim M, Cyr D, Al-Khatib S, et al. Chronic Obstructive Pulmonary Disease is Associated with Increased Risk of Mortality Among Patients with Atrial Fibrillation: Insights from the ARISTOTLE Trial. American Thoracic Society International Conference 2015. 2015

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