Type of publication:
Conference abstract
Author(s):
Sarfraz M.R.; Hemida M.F.; *Ali A.; Ishtiaq S.; Patel K.; Hussein M.; Tabasum P.; Basit Kayani A.; Mehmood H.; Mushtaq I.; Rehman S.;
Citation:
Thorax. Conference: British Thoracic Society Winter Meeting 2025. Westminster . 80(Supplement 2) (pp A71-A73), 2025. Date of Publication: 01 Nov 2025.
Abstract:
Background While arrhythmias are recognized as potential causes of death in chronic obstructive pulmonary disease (COPD) patients. However, temporal trends in arrhythmia-related mortality among COPD patients remain unexamined. Therefore, we conducted a comparative study evaluating mortality trends between atrial fibrillation (AF) and other arrhythmias in COPD patients. Methods A retrospective analysis of was conducted from 1999-2023, using the CDC WONDER database comparing COPD patients with AF (ICD-10: I48) versus other arrhythmias (ICD-10: I47, I49). Age-adjusted mortality rates (AAMRs) per 100,000 population were stratified by demographic variables for adults >=25 years. Joinpoint regression estimated average annual percent changes (AAPC) in mortality trends. Results From 1999-2023, 537,088 COPD-AF deaths were recorded (280,378 Men; 256,710 Women). AAMRs increased significantly from 5.55 to 13.66 (AAPC: +3.87%). Conversely, 168,770 COPD patients with other arrhythmias died (96,472 Men; 72,298 Women), with AAMRs declining significantly from 5.19 to 2.04 (AAPC: -3.56%). Men consistently showed higher mortality rates in both COPD with AF and other arrhythmias. In COPD-AF, AAMRs increased significantly for both genders (p<0.000001): men (7.96 to 16.95; AAPC: +3.23%) and women (4.17 to 11.19; AAPC: +4.18%). Conversely, in the COPD with other arrhythmias cohort, mortality rates decreased significantly (p<0.000001) for both men (AAMR: 7.68 to 2.67; AAPC: -4.05%) and women (AAMR: 3.58 to 1.52; AAPC: -3.16%). Inpatient medical facilities were the most common place of death for both groups, though COPD-AF patients had fewer inpatient deaths (59,284) than those with other arrhythmias (190,982). Both cohorts showed a notable shift toward increased home deaths over the study period. Racially, Whites had the highest AAMRs in both groups (AF: 11.04; other: 3.32), followed by American Indians (AF: 8.18; other: 2.78). Regionally, the Midwest showed highest mortality with opposing trends: upward for AF (AAPC: +4.89%) and downward for other arrhythmias (AAPC: -3.30%) p<0.000001. At state level, Vermont had the highest COPD-AF mortality (AAMR: 16.33), while Ohio had the highest AAMR for other arrhythmias (5.20). Conclusion COPD-AF mortality increased dramatically while other arrhythmia mortality declined significantly. Men showed consistently higher mortality with notable demographic disparities. These opposing trends suggest AF represents an emerging threat requiring targeted interventions.
DOI: 10.1136/thorax-2025-BTSabstracts.104
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