ECG-based identification of COPD patients at risk for atrial fibrillation and its impact on adverse clinical outcomes—a subgroup analysis of the prospective multicenter COSYCONET cohort

Eichenlaub, Martin; Frye, Björn Christian; Lehrmann, Heiko; Biertz, Frank; Jadidi, Amir Sherwan; Kaier, Klaus; Melzer, Thomas; Alter, Peter ; Watz, Henrik; Waschki, Benjamin; Weckler, Barbara Christine; Trudzinski, Franziska Christina; Michels-Zetsche, Julia Dorothea; Trinkmann, Frederik; Herth, Felix Josef-Friedrich; Kauczor, Hans-Ulrich; Kahnert, Kathrin ; Jörres, Rudolf A. ; Bals, Robert; Westermann, Dirk ; Arentz, Thomas; Vogelmeier, Claus Franz; Stolz, Daiana; Fähndrich, Sebastian; Andreas, Stefan; Behr, Jürgen ; Brahmer, Thomas; Bewig, Burkhard; Ewert, Ralf; Stubbe, Beate; Ficker, Joachim Hans; Grohé, Christian; Held, Matthias; Henke, Markus; Kirsten, Anne-Marie; Koczulla, Rembert; Kronsbein, Juliane; Kropf-Sanchen, Cornelia; Herzmann, Christian; Pfeifer, Michael; Randerath, Winfried Johannes; Seeger, Werner ; Studnicka, Michael; Taube, Christian; Timmermann, Hartmut; Schmeck, Bernd; Welte, Tobias und Wirtz, Hubert (2025): ECG-based identification of COPD patients at risk for atrial fibrillation and its impact on adverse clinical outcomes—a subgroup analysis of the prospective multicenter COSYCONET cohort. In: Respiratory Research, Bd. 26, 272

Abstract

Background: Atrial fibrillation (AF) frequently occurs in patients with chronic obstructive pulmonary disease (COPD) and is associated with adverse clinical outcomes. We aimed to identify patients at risk for AF using amplified p-wave duration (APWD) analysis on electrocardiogram (ECG) as non-invasive tool to diagnose an atrial cardiomyopathy (AtCM) which is an established risk factor for AF.

Methods: This subgroup analysis of the prospective COSYCONET cohort included 2,385 COPD patients from 31 study centers with baseline sinus rhythm ECG and at least one follow-up examination. Of these, 73 patients showed AF during follow-up and were propensity-score matched to controls. APWD was measured at baseline and future major adverse cardiac and cerebrovascular events (MACCE) and health related outcome were assessed.

Results: 219 COPD patients (70 [64–74] years, 79.5% male) were analyzed during a follow-up of 586 (210–1137) days. APWD was significantly longer in patients with AF occurrence compared to controls (132 [125–141] ms vs. 124 [117–133] ms, p < 0.001) and remained significant in multivariate regression analysis (OR: 1.05 [1.01–1.09], p = 0.03). An APWD ≥ 131 ms was identified as best cut-off for AF prediction (62% sensitivity, 70% specificity, OR: 3.91 [2.58 to 5.95], p < 0.001). Patients with AF had a significantly higher MACCE rate (24.7% versus 8.2%, p = 0.001) and a significantly lower physical activity score (1,074 [264–4,776] vs. 2,706 [975–7,339], p = 0.008).

Conclusions: This study demonstrates that ECG-based AtCM diagnosis identifies COPD patients at risk for AF, which was associated with a substantially elevated MACCE rate and a significantly reduced physical activity. This easy, cost-effective and widely available digital biomarker might enable early therapy initiation and prevention of adverse clinical outcomes.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1465-993X
• Sprache: Englisch