Chronic obstructive pulmonary disease and sudden cardiac death: A systematic review

https://doi.org/10.1016/j.tcm.2016.04.001Get rights and content
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Abstract

Both chronic obstructive pulmonary disease (COPD) and sudden cardiac death (SCD) are major health burdens. A number of studies have addressed their interrelationship, but currently no systematic review has been published. Our objective is to give an overview of the literature of the association between COPD and SCD. A search on PubMed with both MeSH headings and free-text keywords was performed. We selected all original articles of studies in humans that assessed COPD on the one hand and SCD, electrocardiographic markers for SCD, ventricular arrhythmias, or asystole on the other. The electronic search yielded 251 articles, from which 27 full publications were selected after careful evaluation of the full-text articles. In these studies, COPD was associated with a prolonged and shortened QT interval. In patients with a myocardial infarction (MI), COPD was associated with an increased risk of ventricular arrhythmias and decreased survival. COPD was a risk factor for SCD both in cardiovascular patient groups and in community-based studies, independent from cardiovascular risk profile. Studies of the potential impact of respiratory treatment on the occurrence of SCD showed conflicting results. In conclusion, cumulating evidence associates COPD with an increased risk of SCD. Asystole and pulseless electric activity could be more common than VT/VF in deaths associated with COPD. Underlying mechanisms explaining this association require further investigation.

Key words

COPD
Sudden cardiac death
Ventricular arrhythmia
Cardiac arrest

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Lies Lahousse is a Postdoctoral Fellow of the Research Foundation-Flanders (FWO). No funding source was involved in the selection, review, and interpretation of the data or approval of the article.

G.B. has, within the last 5 years, received honoraria for lectures from AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, MerckSharp&Dohme, Novartis, Pfizer, Teva, and UCB; he is a member of advisory boards for AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline, and Novartis.