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Войти в исследования International journal of chronic obstructive pulmonary disease · 2025
Prevalence and Risk Factors of Arrhythmias in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.
Систематический обзорСтатьяМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Ding Nan, Qiu Weida, Chen Jinmin, Wang Kaihao, Chen Zeyue, Cai Ruli, Chen Ailan
Аннотация
BACKGROUND: Cardiac arrhythmias are commonly seen in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but their prevalence, risk factors, and prognostic significance are still not fully understood.
OBJECTIVE: To estimate the prevalence of arrhythmias in patients with AECOPD, identify related clinical factors, and assess their influence on in-hospital mortality.
METHODS: A systematic search of PubMed, Embase, Web of Science, CENTRAL, and Cochrane Reviews was conducted to identify observational studies and randomized controlled trials. A random-effects meta-analysis using the DerSimonian-Laird method was performed. Subgroup and sensitivity analyses were conducted to explore heterogeneity, and publication bias was assessed using Egger's and Begg's tests.
RESULTS: Twenty-eight studies were included. The pooled prevalence of arrhythmias in AECOPD patients was 15% (95% CI: 12-18%), with considerable heterogeneity (I² = 99.93%). Prevalence was higher in studies from developed countries, particularly those with larger sample sizes and older populations. Advanced age (WMD = 2.79 years) and elevated C-reactive protein levels (WMD = 5.32) were associated with increased arrhythmia risk. Use of long-acting beta-agonists (LABAs) was associated with a reduced risk (OR = 0.42), although the causal mechanism remains uncertain. Arrhythmias were significantly associated with increased in-hospital mortality (RR = 3.33, 95% CI: 3.27-3.38). In a predefined subgroup analysis, atrial fibrillation (AF) was also linked to a higher risk of death (RR = 3.70, 95% CI: 2.40-5.70). Sensitivity analyses confirmed the robustness of these findings, and no significant publication bias was detected.
CONCLUSION: Arrhythmias are common during AECOPD and are associated with increased short-term mortality, especially in patients with AF. Aging and systemic inflammation appear to be key contributors. While LABA use may have a protective association, this finding requires cautious interpretation. Standardized ECG monitoring and individualized risk stratification are warranted to improve patient outcomes.
OBJECTIVE: To estimate the prevalence of arrhythmias in patients with AECOPD, identify related clinical factors, and assess their influence on in-hospital mortality.
METHODS: A systematic search of PubMed, Embase, Web of Science, CENTRAL, and Cochrane Reviews was conducted to identify observational studies and randomized controlled trials. A random-effects meta-analysis using the DerSimonian-Laird method was performed. Subgroup and sensitivity analyses were conducted to explore heterogeneity, and publication bias was assessed using Egger's and Begg's tests.
RESULTS: Twenty-eight studies were included. The pooled prevalence of arrhythmias in AECOPD patients was 15% (95% CI: 12-18%), with considerable heterogeneity (I² = 99.93%). Prevalence was higher in studies from developed countries, particularly those with larger sample sizes and older populations. Advanced age (WMD = 2.79 years) and elevated C-reactive protein levels (WMD = 5.32) were associated with increased arrhythmia risk. Use of long-acting beta-agonists (LABAs) was associated with a reduced risk (OR = 0.42), although the causal mechanism remains uncertain. Arrhythmias were significantly associated with increased in-hospital mortality (RR = 3.33, 95% CI: 3.27-3.38). In a predefined subgroup analysis, atrial fibrillation (AF) was also linked to a higher risk of death (RR = 3.70, 95% CI: 2.40-5.70). Sensitivity analyses confirmed the robustness of these findings, and no significant publication bias was detected.
CONCLUSION: Arrhythmias are common during AECOPD and are associated with increased short-term mortality, especially in patients with AF. Aging and systemic inflammation appear to be key contributors. While LABA use may have a protective association, this finding requires cautious interpretation. Standardized ECG monitoring and individualized risk stratification are warranted to improve patient outcomes.