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Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of hospitalization and is associated with an increased incidence of atrial fibrillation (AF). The impact of AF on in-hospital outcomes, including mortality, in patients hospitalized for COPD exacerbation is not well elucidated.
Methods: We used the National Inpatient Sample database to examine discharges with the primary diagnosis of COPD exacerbation and compared mortality, length of stay and costs in patients with AF compared to those without AF. The study adjusted the outcomes for known cardiovascular risk factors and confounders using logistic regression and propensity score matching analysis.
Results: Among 1,377,795 discharges with COPD exacerbation, 16.6% had AF. Patients with AF were older and had more comorbidities. Mortality was higher (2.4%) in the AF group than in the no AF group (1%), p <0.001. After adjustment to age, sex and confounders, AF remained an independent predictor for mortality, OR:1.44 (95% CI 133 - 1.56, p <0.001), prolonged length of stay, OR:1.63 (95% CI 1.57 - 1.69, p <0.001) and increased cost, OR: 1.45 (95% CI: 1.40 - 1.49, p <0.001).
Conclusions: among patients with COPD exacerbation, AF was associated with increased mortality and higher resource utilization.
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http://dx.doi.org/10.4022/jafib.2117 | DOI Listing |
Am J Respir Crit Care Med
September 2025
Temple University Hospital, Pulm & Crit Care Medicine, Philadelphia, Pennsylvania, United States.
Rationale: AIRFLOW-3 was a 1:1 randomized, double blind, sham controlled trial of the d'Nerva Targeted Lung Denervation (TLD) System in patients with COPD.
Objective: Evaluate the impact of TLD on COPD exacerbations compared to optimal medical treatment.
Methods: AIRFLOW-3 patients were symptomatic (CAT ≥10) with moderate to very severe airflow obstruction (25% ≤ FEV ≤ 80% predicted) and GOLD E status (≥2 moderate or ≥1 severe exacerbation over prior 12 months).
Ann Am Thorac Soc
September 2025
University of California Los Angeles David Geffen School of Medicine, Medicine, Los Angeles, California, United States.
Rationale: Inflammation is central to chronic obstructive pulmonary disease (COPD) pathogenesis but incompletely represented in COPD prognostic models. Neutrophil to lymphocyte ratio (NLR) is a readily available inflammatory biomarker.
Objectives: To explore the associations of NLR with smoking status, clinical features of COPD, and future adverse outcomes.
Introduction Chronic Obstructive Pulmonary Disease (COPD) is increasingly recognized not only as a pulmonary condition but as a systemic disorder with significant cardiovascular implications. Acute exacerbations of COPD (AECOPD) further elevate this risk, potentially through a heightened prothrombotic state. This study aimed to evaluate and compare the levels of select prothrombotic biomarkers - fibrinogen, C-reactive protein (CRP), D-dimer, von Willebrand Factor (vWF), homocysteine, lactate dehydrogenase (LDH), and platelet-to-lymphocyte ratio (PLR) - in patients with stable COPD and AECOPD, and to assess their diagnostic and prognostic significance.
View Article and Find Full Text PDFFront Pharmacol
August 2025
Department of Pharmacy, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Dipeptidyl peptidase 1 (DPP1) inhibitors constitute a major advance in respiratory disease therapeutics. Through selective blockade of neutrophil serine protease (NSP) activation, these agents establish novel treatment paradigms for inflammatory respiratory conditions characterized by neutrophil-driven pathology. This comprehensive review examines the development status, clinical efficacy, and safety profile of DPP1 inhibitors in neutrophil-driven diseases, particularly non-cystic fibrosis bronchiectasis (NCFBE) and chronic obstructive pulmonary disease (COPD).
View Article and Find Full Text PDFInt J Chron Obstruct Pulmon Dis
September 2025
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.
Background: Chronic obstructive pulmonary disease (COPD) is a major health concern in Korea, with a higher burden of acute exacerbations (AE-COPD) compared to Western populations. Environmental exposures such as smoking and air pollution are known contributors, but the impact of urban green space remains underexplored.
Methods: We conducted a cohort study using the Korean National Health Insurance Service-National Sample Cohort (2006-2019), including 5,171 patients aged ≥40 years with at least two COPD-related prescriptions within one year.