Evidence map›Paper›PMID 40963108›Full record

ArticleRespiratory research2025

ECG-based identification of COPD patients at risk for atrial fibrillation and its impact on adverse clinical outcomes-a subgroup analysis of the prospective multicenter COSYCONET cohort.

Martin Eichenlaub, Björn Christian Frye, Heiko Lehrmann, Frank Biertz, Amir Sherwan Jadidi, Klaus Kaier, Thomas Melzer, Peter Alter, Henrik Watz, Benjamin Waschki and 15 more

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01245933 (Impact of Systemic Manifestations/Comorbidities on Clinical State, Prognosis and Utilisation of Health Care Resources in Patients With COPD), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01245933 completednot on this map

Impact of Systemic Manifestations/Comorbidities on Clinical State, Prognosis and Utilisation of Health Care Resources in Patients With COPD

TypeobservationalSponsorPhilipps University MarburgRan2010 to 2023Enrolled2,741ConditionsChronic Obstructive Pulmonary Disease (COPD)
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Martin EichenlaubDepartment of Pneumology, Medical Center, Faculty of Medicine, University of Freiburg, Killianstrasse 5, Freiburg, 79106, Germany. martin.eichenlaub@uniklinik-freiburg.de.
Björn Christian FryeDepartment of Pneumology, Medical Center, Faculty of Medicine, University of Freiburg, Killianstrasse 5, Freiburg, 79106, Germany.
Heiko LehrmannDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University of Freiburg, Suedring 15, Freiburg, Bad Krozingen, 79189, Germany.
Frank BiertzHannover Medical School, CAPNETZ Stiftung, Hannover, Germany.
Amir Sherwan JadidiDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University of Freiburg, Suedring 15, Freiburg, Bad Krozingen, 79189, Germany.
Klaus KaierInstitute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Thomas MelzerDepartment of Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), Munich, Germany.
Peter AlterDepartment of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps-University Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany.
Henrik WatzAirway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, Germany.
Benjamin WaschkiAirway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, Germany.
Barbara Christine WecklerDepartment of Medicine, Pulmonary and Critical Care Medicine, Clinic for Airway Infections,, University Medical Centre Marburg, Philipps-University Marburg, Marburg, Germany.
Franziska Christina TrudzinskiDepartment of Pneumology and Critical Care, Research (DZL), Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung, Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany.
Julia Dorothea Michels-ZetscheDepartment of Pneumology and Critical Care, Research (DZL), Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung, Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany.
Frederik TrinkmannDepartment of Pneumology and Critical Care, Research (DZL), Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung, Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany.
Felix Josef-Friedrich HerthDepartment of Pneumology and Critical Care, Research (DZL), Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung, Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany.
Hans-Ulrich KauczorDiagnostic and Interventional Radiology, Member of the German Center of Lung Research, University Hospital Heidelberg, Heidelberg, Germany.
Kathrin KahnertDepartment of Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), Munich, Germany.
Rudolf JörresInstitute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich, Germany.
Robert BalsDepartment of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany.
Dirk WestermannDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University of Freiburg, Suedring 15, Freiburg, Bad Krozingen, 79189, Germany.
Thomas ArentzDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University of Freiburg, Suedring 15, Freiburg, Bad Krozingen, 79189, Germany.
Claus Franz VogelmeierDepartment of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps-University Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany.
Daiana StolzDepartment of Pneumology, Medical Center, Faculty of Medicine, University of Freiburg, Killianstrasse 5, Freiburg, 79106, Germany.
Sebastian FähndrichDepartment of Pneumology, Medical Center, Faculty of Medicine, University of Freiburg, Killianstrasse 5, Freiburg, 79106, Germany. sebastian.faehndrich@uniklinik-freiburg.de.
German COSYCONET cohort

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtrial fibrillation (AF) frequently occurs in patients with chronic obstructive pulmonary disease (COPD) and is associated with adverse clinical outcomes. We aimed to identify patients at risk for AF using amplified p-wave duration (APWD) analysis on electrocardiogram (ECG) as non-invasive tool to diagnose an atrial cardiomyopathy (AtCM) which is an established risk factor for AF.

methodsThis subgroup analysis of the prospective COSYCONET cohort included 2,385 COPD patients from 31 study centers with baseline sinus rhythm ECG and at least one follow-up examination. Of these, 73 patients showed AF during follow-up and were propensity-score matched to controls. APWD was measured at baseline and future major adverse cardiac and cerebrovascular events (MACCE) and health related outcome were assessed.

results219 COPD patients (70 [64-74] years, 79.5% male) were analyzed during a follow-up of 586 (210-1137) days. APWD was significantly longer in patients with AF occurrence compared to controls (132 [125-141] ms vs. 124 [117-133] ms, p < 0.001) and remained significant in multivariate regression analysis (OR: 1.05 [1.01-1.09], p = 0.03). An APWD ≥ 131 ms was identified as best cut-off for AF prediction (62% sensitivity, 70% specificity, OR: 3.91 [2.58 to 5.95], p < 0.001). Patients with AF had a significantly higher MACCE rate (24.7% versus 8.2%, p = 0.001) and a significantly lower physical activity score (1,074 [264-4,776] vs. 2,706 [975-7,339], p = 0.008).

conclusionsThis study demonstrates that ECG-based AtCM diagnosis identifies COPD patients at risk for AF, which was associated with a substantially elevated MACCE rate and a significantly reduced physical activity. This easy, cost-effective and widely available digital biomarker might enable early therapy initiation and prevention of adverse clinical outcomes.

trial registrationNCT01245933 on Clinical-Trials.gov (Registration date: 22.11.2010).

Indexed as

Atrial FibrillationElectrocardiographyPulmonary Disease, Chronic ObstructiveAgedCohort StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesRisk FactorsAtrial fibrillationBiomarkerCOPDElectrocardiographyMACCEScreening

Identifiers

PMID40963108
PMCPMC12442265

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.