Chronic Obstructive Pulmonary Disease as Risk Factor for Ischemic Cerebrovascular Accident - Abstract
Rationale: Atrial Fibrillation (AF) is a potent risk factor for ischemic cerebrovascular Accident (ICVA). Inflammation is potential pathogenic factor for atherosclerosis and ICVA. Chronic Obstructive pulmonary disease (COPD) is associated with increased inflammatory markers. Subjects frequently suffer from COPD and AF, may have higher risk for ICVA.
Methods: Single center cross sectional study was performed. All subjects with diagnosis of COPD, AF and ICVA for duration of 5 years were categorized in three groups; COPD, AF, and COPD plus AF. Prevalence of ICVA was compared. Presence of confounding factors affecting ICVA risk was recorded for all subjects; age >65, type 2 Diabetes, Hypertension, peripheral vascular disease, dyslipidemia, and Congestive cardiac failure.
Results: Total charts reviewed were 1821; only COPD 887, only AF 684, and both together 250. ICVA was documented in total 484 (26.6%) subjects. Individuals who had COPD and AF were 1.86 (95% CI 1.34 to 2.58, p<0.001) times as likely to have an ICVA compared to subjects who only have COPD or AF. Prevalence of ICVA was also significantly higher in subjects who have only AF versus those who have only COPD (P<0.001). In logistic Regression model while adjusting for all significantly different confounding factors, AF and COPD was found to be strong predictor of ICVA (p<0.001), much stronger than AF only (p=0.04). Odd ratio was 1.28 (95% CI 1.003 to 1.65) for AF only.
Conclusion: Presence of COPD may increase the risk of ischemic stroke in subjects with Atrial Fibrillation.