Stroke Risk in AF Linked With Hospitalization for Acute Exacerbation of COPD

Significant risk for stroke is found in patients with atrial fibrillation (AF) hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), according to study results presented at Heart Rhythm 2025, held from April 24 to 27, 2025, in San Diego, California.

Investigators evaluated the possible association between AF in patients hospitalized for AECOPD with subsequent cerebrovascular accidents (CVAs).

The investigators conducted an observational study identifying patients with any implantable Medtronic cardiac rhythm device who had an AECOPD hospitalization between 2007 and 2021, using the Optum® de-identified electronic health record dataset linked with the Medtronic CareLink^TM. The study cohort was stratified based on maximum daily AF burden (no AF; AF<6 minutes; AF 6 min to 23 hours; AF ≥24 hrs).

The investigators included 28,448 hospitalizations in 12,903 patients (mean age, 63 [SD, 17] years; 57% men) in the analysis. During the 12 months following hospitalization, AF was present in 19% of the AF for less than 6 min group, 9% in the AF for 6 min to 23 hrs group, and 15% of the AF for 24 hrs or longer group. During this period, 49% of events (11,899) resulted in CVA.

Relative to no AF or AF for less than 6 min (unadjusted odds ratio [OR], 1.96; 95% CI, 1.57-2.44) and AF for 6 min to 23 hrs (OR, 1,53; 95% CI, 1.22-1.91) was associated with risk for subsequent stroke. There was elevated risk for stroke in patients with AF for 24 hrs or longer relative to patients with no AF (OR, 1.75; 95% CI, 1.53-2.00) or AF for less than 6 min (OR, 1.36; 95% CI, 1.18-1.57). Compared with patients with AF for 6 min to 23 hrs, those with AF for 24 hrs or longer did not have higher odds of CVA (OR, 0.89; 95% CI, 0.70-1.14).

Stroke is common following AECOPD hospitalization. “Maximum daily burden of AF of less than 6 minutes at the time of AECOPD hospitalization showed higher odds of subsequent CVA over 12 months relative to AF [of] less than 6 minutes and was no different than AF of 24 hours,” the investigators concluded. “These data suggest that AF associated with hospitalization for AECOPD poses significant risk for subsequent stroke.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on The Cardiology Advisor