Skip to main content
SpringerLink
Log in

Major adverse cardiovascular events in non-valvular atrial fibrillation with chronic obstructive pulmonary disease: the ARAPACIS study

  • IM - ORIGINAL
  • Published:
Internal and Emergency Medicine Aims and scope Submit manuscript

A Correction to this article was published on 03 August 2018

This article has been updated

Abstract

Chronic obstructive pulmonary disease (COPD) increases the risk of mortality in non-valvular atrial fibrillation (NVAF) patients. Data on the relationship of COPD to major cardiovascular events (MACE) in AF have not been defined. The aim of the study is to assess the predictive value of COPD on incident MACE in NVAF patients over a 3-year follow-up. In the Atrial Fibrillation Registry for Ankle-Brachial Index Prevalence Assessment-Collaborative Italian Study (ARAPACIS) cohort, we evaluate the impact of COPD on the following clinical endpoints: MACE (including vascular death, fatal/non-fatal MI and stroke/TIA), cardiovascular (CV) death and all-cause mortality. Among 2027 NVAF patients, patients with COPD (9%) are more commonly male, elderly and at higher thromboembolic risk. During a median 36.0 months follow-up, 186 patients experienced MACE: vascular death (n = 72), MI (n = 57), stroke/TIA (n = 57). All major outcomes (including stroke/TIA, MI, vascular death, and all-cause death) are centrally adjudicated. Kaplan–Meier curves show that NVAF patients with COPD are at higher risk for MACE (p < 0.001), CV death (p < 0.001) and all-cause death (p < 0.001). On Cox proportional hazard analysis, COPD is an independent predictor of MACE (Hazard ratio [HR] 1.77, 95% Confidence Intervals [CI] 1.20–2.61; p = 0.004), CV death (HR 2.73, 95% CI 1.76–4.23; p < 0.0001) and all-cause death (HR 2.16, 95% CI 1.48–3.16; p < 0.0001). COPD is an independent predictor of MACE, CV death and all-cause death during a long-term follow-up of NVAF patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Change history

  • 03 August 2018

    In the original publication, one of the ARAPACIS collaborators Dr. “Leonardo Di Gennaro” name has been erroneously mentioned as “Leonardo De Gennaro”.

References

  1. Vestbo J, Hurd SS, Agusti AG et al (2013) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 187:347–365

    Article  CAS  PubMed  Google Scholar 

  2. Bousquet J, Dahl R, Khaltaev N (2007) Global alliance against chronic respiratory diseases. Eur Respir J 29:233–239

    Article  CAS  PubMed  Google Scholar 

  3. Ambrosino P, Lupoli R, Iervolino S, De Felice A, Pappone N, Storino A, Di Minno MND (2017) Clinical assessment of endothelial function in patients with chronic obstructive pulmonary disease: a systematic review with meta-analysis. Intern Emerg Med 12:877–885

    Article  PubMed  Google Scholar 

  4. Diez-Manglano J, Barquero-Romero J, Almagro P et al (2014) COPD patients with and without metabolic syndrome: clinical and functional differences. Intern Emerg Med 9:419–425

    Article  PubMed  Google Scholar 

  5. Roversi S, Fabbri LM, Sin DD, Hawkins NM, Agusti A (2016) Chronic obstructive pulmonary disease and cardiac diseases: an urgent need for integrated care. Am J Respir Crit Care Med 194:1319–1336

    Article  PubMed  Google Scholar 

  6. Cavailles A, Brinchault-Rabin G, Dixmier A et al (2013) Comorbidities of COPD. Eur Respir Rev 22:454–475

    Article  PubMed  Google Scholar 

  7. Catella F, Healy D, Lawson JA, FitzGerald GA (1986) 11-Dehydrothromboxane B2: a quantitative index of thromboxane A2 formation in the human circulation. Proc Natl Acad Sci USA 83:5861–5865

    Article  CAS  PubMed  Google Scholar 

  8. Davi G, Basili S, Vieri M et al (1997) Enhanced thromboxane biosynthesis in patients with chronic obstructive pulmonary disease. The Chronic Obstructive Bronchitis and Haemostasis Study Group. Am J Respir Crit Care Med 156:1794–1799

    Article  CAS  PubMed  Google Scholar 

  9. Soliman EZ, Safford MM, Muntner P et al (2014) Atrial fibrillation and the risk of myocardial infarction. JAMA Internal Med 174:107–114

    Article  Google Scholar 

  10. Violi F, Soliman EZ, Pignatelli P, Pastori D (2016) Atrial fibrillation and myocardial infarction: a systematic review and appraisal of pathophysiologic mechanisms. J Am Heart Assoc 5:e003347

    Article  PubMed  PubMed Central  Google Scholar 

  11. Pokorney SD, Piccini JP, Stevens SR et al (2016) Cause of death and predictors of all-cause mortality in anticoagulated patients with nonvalvular atrial fibrillation: data from ROCKET AF. J Am Heart Assoc 5:e002197

    Article  PubMed  PubMed Central  Google Scholar 

  12. Durheim MT, Cyr DD, Lopes RD et al (2016) Chronic obstructive pulmonary disease in patients with atrial fibrillation: insights from the ARISTOTLE trial. Int J Cardiol 202:589–594

    Article  PubMed  Google Scholar 

  13. Proietti M, Laroche C, Drozd M et al (2016) Impact of chronic obstructive pulmonary disease on prognosis in atrial fibrillation: a report from the EURObservational Research Programme Pilot Survey on Atrial Fibrillation (EORP-AF) General Registry. Am Heart J 181:83–91

    Article  PubMed  Google Scholar 

  14. Violi F, Davi G, Proietti M et al (2016) Ankle-Brachial Index and cardiovascular events in atrial fibrillation. The ARAPACIS Study, Thromb Haemost, p 115

    Google Scholar 

  15. Violi F, Davi G, Hiatt W et al (2013) Prevalence of peripheral artery disease by abnormal ankle-brachial index in atrial fibrillation: implications for risk and therapy. J Am Coll Cardiol 62:2255–2256

    Article  PubMed  Google Scholar 

  16. Raparelli V, Proietti M, Butta C et al (2014) Medication prescription and adherence disparities in non valvular atrial fibrillation patients: an Italian portrait from the ARAPACIS study. Intern Emerg Med 9:861–870

    Article  PubMed  Google Scholar 

  17. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ (2010) Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest 137:263–272

    Article  PubMed  Google Scholar 

  18. Kirchhof P, Benussi S, Kotecha D et al (2016) 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS: The Task Force for the management of atrial fibrillation of the European Society of Cardiology (ESC)Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESCEndorsed by the European Stroke Organisation (ESO). European heart journal

  19. Thygesen K, Alpert JS, White HD et al (2007) Universal definition of myocardial infarction. Circulation 116:2634–2653

    Article  Google Scholar 

  20. Whisnant JP, Basford JR, Bernstein EF et al. (1990) Classification of cerebrovascular diseases III. Stroke 21:637–676

    Article  Google Scholar 

  21. Miller AJ (2002) Subset selection in regression. CRC monographs on statistics and applied probability. Chapman & Hall, CRC Press

    Book  Google Scholar 

  22. Pastori D, Pignatelli P, Saliola M et al (2015) Inadequate anticoagulation by vitamin K Antagonists is associated with major adverse cardiovascular events in patients with atrial fibrillation. Int J Cardiol 201:513–516

    Article  PubMed  Google Scholar 

  23. Pastori D, Pignatelli P, Farcomeni A et al (2015) Urinary 11-dehydro-thromboxane B2 is associated with cardiovascular events and mortality in patients with atrial fibrillation. Am Heart J 170(490–497):e491

    Google Scholar 

  24. Pastori D, Pignatelli P, Farcomeni A, Nocella C, Bartimoccia S, Carnevale R, Violi F (2016) Age-related increase of thromboxane B2 and risk of cardiovascular disease in atrial fibrillation. Oncotarget 7:39143–39147

    Article  PubMed  PubMed Central  Google Scholar 

  25. Pastori D, Pignatelli P, Angelico F et al (2015) Incidence of myocardial infarction and vascular death in elderly patients with atrial fibrillation taking anticoagulants: relation to atherosclerotic risk factors. Chest 147:1644–1650

    Article  PubMed  Google Scholar 

  26. Camm AJ, Amarenco P, Haas S et al (2015) XANTUS: a real-world, prospective, observational study of patients treated with rivaroxaban for stroke prevention in atrial fibrillation. Eur Heart J 37:1145–4453

    Article  PubMed  PubMed Central  Google Scholar 

  27. Pastori D, Pignatelli P, Angelico F et al (2015) Incidence of myocardial infarction and vascular death in elderly patients with atrial fibrillation taking anticoagulants: relation to atherosclerotic risk factors. Chest 147:1644–1650

    Article  PubMed  Google Scholar 

  28. Larsen TB, Rasmussen LH, Gorst-Rasmussen A, Skjoth F, Rosenzweig M, Lane DA, Lip GY (2014) Myocardial ischemic events in ‘real world’ patients with atrial fibrillation treated with dabigatran or warfarin. Am J Med 127(329–336):e324

    Google Scholar 

  29. Ferroni P, Basili S, Pulcinelli FM, Pettirossi G, Alessandri C, Violi F, Gazzaniga PP, Cordova C (1994) In vivo thrombin generation and platelet hyperactivity in patients with chronic obstructive pulmonary disease. Platelets 5:276–278

    Article  CAS  PubMed  Google Scholar 

  30. Malerba M, Clini E, Malagola M, Avanzi GC (2013) Platelet activation as a novel mechanism of atherothrombotic risk in chronic obstructive pulmonary disease. Expert Rev Hematol 6:475–483

    Article  CAS  PubMed  Google Scholar 

  31. Proietti M, Nobili A, Raparelli V, Napoleone L, Mannucci PM, Lip GY, Investigators R (2016) Adherence to antithrombotic therapy guidelines improves mortality among elderly patients with atrial fibrillation: insights from the REPOSI study. Clin Res Cardiol 105:912–920

    Article  CAS  PubMed  Google Scholar 

  32. Pignatelli P, Pastori D, Bartimoccia S, Menichelli D, Vicario T, Nocella C, Carnevale R, Violi F (2016) Anti Xa oral anticoagulants inhibit in vivo platelet activation by modulating glycoprotein VI shedding. Pharmacol Res 113:484–489

    Article  CAS  PubMed  Google Scholar 

  33. Mitchell JA, Knowles RB, Kirkby NS et al (2018) Kidney transplantation in a patient lacking cytosolic phospholipase A2 Proves Renal Origins of urinary PGI-M and TX-M. Circ Res 122:555–559

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Grosser T, Naji A, FitzGerald GA (2018) Urinary prostaglandin metabolites: an incomplete reckoning and a flush to judgment. Circ Res 122:537–539

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Dr. Hiatt reports grants from Bayer, Janssen and AstraZeneca, outside the submitted work. ARAPACIS STUDY Collaborators Alessandri C., Serviddio G., Palange P., Greco E., Bruno G., Averna M., Giammanco A., Sposito P., De Cristofaro R., Carulli L., De Gennaro L., Pellegrini E. Cominacini L., Mozzini C., Pasini A.F.; Sprovieri M., Spagnuolo V., Cerqua G., Cerasola G., Mulé G., Barbagallo M., Lo Sciuto S., Monteverde A., Saitta A., Lo Gullo A., Malatino L., Cilia C., Terranova V., Pisano M., Pinto A., Di Raimondo D., Tuttolomondo A., Conigliaro R., Signorelli S., De Palma D., Galderisi M., Cudemo G., Galletti F., Fazio V., De Luca N., Meccariello A., Caputo D., De Donato M. T., Iannuzi A., Bresciani A., Giunta R., Utili R., Iorio V., Adinolfi L.E., Sellitto C., Iuliano N., Bellis P., Tirelli P., Sacerdoti D., Vanni D., Iuliano L., Ciacciarelli M., Pacelli A., Palazzuoli A., Cacciafesta M., Gueli N., Lo Iacono C., Brusco S., Verrusio W., Nobili L., Tarquinio N., Pellegrini F., Vincentelli G.M., Ravallese F., Santini C., Letizia C., Petramala L., Zinnamosca L., Minisola S., Cilli M., Colangelo L., Falaschi P., Martocchia A., Pastore F., Bertazzoni G., Attalla El Halabieh E., Paradiso M., Lizzi E.M., Timmi S., Battisti P., Cerci S., Ciavolella M., Di Veroli C., Malci F., De Ciocchis A., Abate D., Castellino P., Zanoli L., Fidone F., Mannarino E., Pasqualini L., Oliverio G., Pende A., Artom N., Ricchio R., Fimognari F.L., Alletto M., Messina S., Sesti G., Arturi F., Succurro E, Fiorentino T.V., Pedace E., Scarpino P.E., Carullo G., Maio R., Sciacqua A., Frugiuele P., Spagnuolo V., Battaglia G., Atzori S., Delitala G., Angelucci E., Sestili S., Traisci G., De Feudis L., Di Michele D., Fava A., Balsano C., De Ciantis P., Desideri G., Camerota A., Mezzetti M., Gresele P., Vedovati C., Fierro T., Puccetti L., Bertolotti M., Mussi C., Boddi M., Savino A., Contri S., Degl’Innocenti G., Saller A., Fabris F., Pesavento R., Filippi L., Vedovetto V., Puato M., Fabris F., Treleani M., De Luca E., De Zaiacomo F., Giantin V., Semplicini A., Minuz P., Romano S., Fantin F., Manica A., Stockner I., Pattis P., Gutmann B., Catena C., Colussi G., Sechi L.A., Annoni G., Bruni A.A., Castagna A., Spinelli D., Miceli E., Padula D., Schinco G., Spreafico S., Secchi B., Vanoli M., Casella G., Pulixi E.A., Sansone L., Serra M.G., Longo S., Antonaci S., Belfiore A., Frualdo M., Palasciano G., Ricci L., Ventrella F., Bianco C., Santovito D., Cipollone F., Nicolai S., Salvati F., Rini G. B., Scozzari F., Muiesan M.L., Salvetti M., Bazza A., Picardi A., Vespasiani-Gentilucci U., De Vincentis A., Cosio P., Terzolo M., Madaffari B., Parasporo B., Fenoglio L., Bracco C., Melchio R., Gentili T., Salvi A., Nitti C., Gabrielli A., Martino G.P., Capucci A., Brambatti M., Sparagna A., Tirotta D., Andreozzi P., Ettorre E., Viscogliosi G., Servello A., Musumeci M., Delfino M., Giorgi A., Glorioso N., Melis G., Marras G., Matta M., Sacco A., Stellitano E., Scordo A., Russo F., Caruso A.A., Porreca E., Tana M., Ferri C., Cheli P., Portincasa P., Muscianisi G., Giordani S., Stanghellini V., Sabbà C., Mancuso G., Bartone M., Calipari D., Arcidiacono G., Bellanuova I., Ferraro M., Marigliano G., Cozzolino D., Lampitella A., Acri V., Galasso D., Mazzei F., Buratti A., Galasso S., Porta M., Brizzi M.F., Fattorini A., Sampietro F., D’Angelo A., Manfredini R., Pala M., Fabbian F., Moroni C., Valente L., Lopreiato F., Parente F., Granata M., Moia M., Braham S., Rossi M., Pesce M., Gentile A., Catozzo V., Baciarello G., Cosimati A., Ageno W., Rancan E., Guasti L., Ciccaglioni A., Negri S., Polselli M., Prisco D., Marcucci R., Ferro D., Perri L.,, Cangemi R., Saliola M., Del Ben M., Angelico F., Baratta F., Migliacci R., Porciello G., Corrao S. Data entry and Safety Monitoring Board: Proietti M., Raparelli V., Napoleone L., Talerico G., Amoroso D., Romiti G.F., Ruscio E., Toriello F., Sperduti N., Todisco T., Di Tanna G., Sacchetti M.L., Puddu P.E., Farcomeni A. Simi Young Internists Group: Anzaldi M., Bazzini C., Bianchi P.I., Boari B., Bracco C., Buonauro A., Buttà C., Buzzetti E., Calabria S., Capeci W., Caradio F., Carleo P., Carrabba M.D., Castorani L., Cecchetto L., Cicco S., Cimini C., Colombo B.M., De Giorgi A., De Vuono S., Del Corso L., Denegri A., Di Giosia P., Durante Mangoni E., Falsetti L., Forgione A., Giorgini P., Grassi D., Grembiale A., Hijazi D., Iamele L., Lorusso G., Marchese A., Marra A.M., Masala M., Miceli G., Montebianco Abenavoli L., Murgia G., Naccarato P., Padula D., Pattoneri P., Perego F., Pesce P., Piano S., Pinna M., Pinto D., Pretti V., Pucci G., Salinaro F., Salzano A., Santilli F., Scarpini F., Scicali R., Sirico D., Suppressa P., Talia M., Tassone E.J., Torres D., Vazzana N., Vecchio C.R., Vidili G., Vitale F., Zaccone V.

Author information

Authors and Affiliations

  1. Department of Internal Medicine and Medical Specialties, Clinica Medica, Atherothrombosis Center, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    Valeria Raparelli, Daniele Pastori, Serena Francesca Pignataro, Pasquale Pignatelli, Roberto Cangemi, Francesco Violi & Stefania Basili

  2. Department of Public Health and Infections Disease, Sapienza University of Rome, Rome, Italy

    Anna Rita Vestri

  3. University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Birmingham, UK

    Marco Proietti & Gregory Yoke Hong Lip

  4. Department of Medicine and Aging, University of Chieti “G. d’Annunzio, Chieti, Italy

    Giovanni Davì

  5. Division of Cardiology, University of Colorado School of Medicine and CPC Clinical Research, Aurora, CO, USA

    William Robert Hiatt

  6. First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy

    Gino Roberto Corazza

  7. Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Catanzaro, Italy

    Francesco Perticone

Authors
  1. Valeria Raparelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniele Pastori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Serena Francesca Pignataro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna Rita Vestri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pasquale Pignatelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Roberto Cangemi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marco Proietti
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Giovanni Davì
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. William Robert Hiatt
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Gregory Yoke Hong Lip
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Gino Roberto Corazza
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Francesco Perticone
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Francesco Violi
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Stefania Basili
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

ARAPACIS Study Collaborators

  • C. Alessandri
  • , G. Serviddio
  • , P. Palange
  • , E. Greco
  • , G. Bruno
  • , M. Averna
  • , A. Giammanco
  • , P. Sposito
  • , R. De Cristofaro
  • , L. Carulli
  • , L. De Gennaro
  • , E. Pellegrini
  • , L. Cominacini
  • , C. Mozzini
  • , A. F. Pasini
  • , M. Sprovieri
  • , V. Spagnuolo
  • , G. Cerqua
  • , G. Cerasola
  • , G. Mulé
  • , M. Barbagallo
  • , S. Lo Sciuto
  • , A. Monteverde
  • , A. Saitta
  • , A. Lo Gullo
  • , L. Malatino
  • , C. Cilia
  • , V. Terranova
  • , M. Pisano
  • , A. Pinto
  • , D. Di Raimondo
  • , A. Tuttolomondo
  • , R. Conigliaro
  • , S. Signorelli
  • , D. De Palma
  • , M. Galderisi
  • , G. Cudemo
  • , F. Galletti
  • , V. Fazio
  • , N. De Luca
  • , A. Meccariello
  • , D. Caputo
  • , M. T. De Donato
  • , A. Iannuzi
  • , A. Bresciani
  • , R. Giunta
  • , R. Utili
  • , V. Iorio
  • , L. E. Adinolfi
  • , C. Sellitto
  • , N. Iuliano
  • , P. Bellis
  • , P. Tirelli
  • , D. Sacerdoti
  • , D. Vanni
  • , L. Iuliano
  • , M. Ciacciarelli
  • , A. Pacelli
  • , A. Palazzuoli
  • , M. Cacciafesta
  • , N. Gueli
  • , C. Lo Iacono
  • , S. Brusco
  • , W. Verrusio
  • , L. Nobili
  • , N. Tarquinio
  • , F. Pellegrini
  • , G. M. Vincentelli
  • , F. Ravallese
  • , C. Santini
  • , C. Letizia
  • , L. Petramala
  • , L. Zinnamosca
  • , S. Minisola
  • , M. Cilli
  • , L. Colangelo
  • , P. Falaschi
  • , A. Martocchia
  • , F. Pastore
  • , G. Bertazzoni
  • , E. Attalla El Halabieh
  • , M. Paradiso
  • , E. M. Lizzi
  • , S. Timmi
  • , P. Battisti
  • , S. Cerci
  • , M. Ciavolella
  • , C. Di Veroli
  • , F. Malci
  • , A. De Ciocchis
  • , D. Abate
  • , P. Castellino
  • , L. Zanoli
  • , F. Fidone
  • , E. Mannarino
  • , L. Pasqualini
  • , G. Oliverio
  • , A. Pende
  • , N. Artom
  • , R. Ricchio
  • , F. L. Fimognari
  • , M. Alletto
  • , S. Messina
  • , G. Sesti
  • , F. Arturi
  • , E. Succurro
  • , T. V. Fiorentino
  • , E. Pedace
  • , P. E. Scarpino
  • , G. Carullo
  • , R. Maio
  • , A. Sciacqua
  • , P. Frugiuele
  • , V. Spagnuolo
  • , G. Battaglia
  • , S. Atzori
  • , G. Delitala
  • , E. Angelucci
  • , S. Sestili
  • , G. Traisci
  • , L. De Feudis
  • , D. Di Michele
  • , A. Fava
  • , C. Balsano
  • , P. De Ciantis
  • , G. Desideri
  • , A. Camerota
  • , M. Mezzetti
  • , P. Gresele
  • , C. Vedovati
  • , T. Fierro
  • , L. Puccetti
  • , M. Bertolotti
  • , C. Mussi
  • , M. Boddi
  • , A. Savino
  • , S. Contri
  • , G. Degl’Innocenti
  • , A. Saller
  • , F. Fabris
  • , R. Pesavento
  • , L. Filippi
  • , V. Vedovetto
  • , M. Puato
  • , F. Fabris
  • , M. Treleani
  • , E. De Luca
  • , F. De Zaiacomo
  • , V. Giantin
  • , A. Semplicini
  • , P. Minuz
  • , S. Romano
  • , F. Fantin
  • , A. Manica
  • , I. Stockner
  • , P. Pattis
  • , B. Gutmann
  • , C. Catena
  • , G. Colussi
  • , L. A. Sechi
  • , G. Annoni
  • , A. A. Bruni
  • , A. Castagna
  • , D. Spinelli
  • , E. Miceli
  • , D. Padula
  • , G. Schinco
  • , S. Spreafico
  • , B. Secchi
  • , M. Vanoli
  • , G. Casella
  • , E. A. Pulixi
  • , L. Sansone
  • , M. G. Serra
  • , S. Longo
  • , S. Antonaci
  • , A. Belfiore
  • , M. Frualdo
  • , G. Palasciano
  • , L. Ricci
  • , F. Ventrella
  • , C. Bianco
  • , D. Santovito
  • , F. Cipollone
  • , S. Nicolai
  • , F. Salvati
  • , G. B. Rini
  • , F. Scozzari
  • , M. L. Muiesan
  • , M. Salvetti
  • , A. Bazza
  • , A. Picardi
  • , U. Vespasiani-Gentilucci
  • , A. De Vincentis
  • , P. Cosio
  • , M. Terzolo
  • , B. Madaffari
  • , B. Parasporo
  • , L. Fenoglio
  • , C. Bracco
  • , R. Melchio
  • , T. Gentili
  • , A. Salvi
  • , C. Nitti
  • , A. Gabrielli
  • , G. P. Martino
  • , A. Capucci
  • , M. Brambatti
  • , A. Sparagna
  • , D. Tirotta
  • , P. Andreozzi
  • , E. Ettorre
  • , G. Viscogliosi
  • , A. Servello
  • , M. Musumeci
  • , M. Delfino
  • , A. Giorgi
  • , N. Glorioso
  • , G. Melis
  • , G. Marras
  • , M. Matta
  • , A. Sacco
  • , E. Stellitano
  • , A. Scordo
  • , F. Russo
  • , A. A. Caruso
  • , E. Porreca
  • , M. Tana
  • , C. Ferri
  • , P. Cheli
  • , P. Portincasa
  • , G. Muscianisi
  • , S. Giordani
  • , V. Stanghellini
  • , C. Sabbà
  • , G. Mancuso
  • , M. Bartone
  • , D. Calipari
  • , G. Arcidiacono
  • , I. Bellanuova
  • , M. Ferraro
  • , G. Marigliano
  • , D. Cozzolino
  • , A. Lampitella
  • , V. Acri
  • , D. Galasso
  • , F. Mazzei
  • , A. Buratti
  • , S. Galasso
  • , M. Porta
  • , M. F. Brizzi
  • , A. Fattorini
  • , F. Sampietro
  • , A. D’Angelo
  • , R. Manfredini
  • , M. Pala
  • , F. Fabbian
  • , C. Moroni
  • , L. Valente
  • , F. Lopreiato
  • , F. Parente
  • , M. Granata
  • , M. Moia
  • , S. Braham
  • , M. Rossi
  • , M. Pesce
  • , A. Gentile
  • , V. Catozzo
  • , G. Baciarello
  • , A. Cosimati
  • , W. Ageno
  • , E. Rancan
  • , L. Guasti
  • , A. Ciccaglioni
  • , S. Negri
  • , M. Polselli
  • , D. Prisco
  • , R. Marcucci
  • , D. Ferro
  • , L. Perri
  • , R. Cangemi
  • , M. Saliola
  • , M. Del Ben
  • , F. Angelico
  • , F. Baratta
  • , R. Migliacci
  • , G. Porciello
  • , S. Corrao
  • , M. Proietti
  • , V. Raparelli
  • , L. Napoleone
  • , G. Talerico
  • , D. Amoroso
  • , G. F. Romiti
  • , E. Ruscio
  • , F. Toriello
  • , N. Sperduti
  • , T. Todisco
  • , G. Di Tanna
  • , M. L. Sacchetti
  • , P. E. Puddu
  • , A. Farcomeni
  • , M. Anzaldi
  • , C. Bazzini
  • , P. I. Bianchi
  • , B. Boari
  • , C. Bracco
  • , A. Buonauro
  • , C. Buttà
  • , E. Buzzetti
  • , S. Calabria
  • , W. Capeci
  • , F. Caradio
  • , P. Carleo
  • , M. D. Carrabba
  • , L. Castorani
  • , L. Cecchetto
  • , S. Cicco
  • , C. Cimini
  • , B. M. Colombo
  • , A. De Giorgi
  • , S. De Vuono
  • , L. Del Corso
  • , A. Denegri
  • , P. Di Giosia
  • , E. Durante Mangoni
  • , L. Falsetti
  • , A. Forgione
  • , P. Giorgini
  • , D. Grassi
  • , A. Grembiale
  • , D. Hijazi
  • , L. Iamele
  • , G. Lorusso
  • , A. Marchese
  • , A. M. Marra
  • , M. Masala
  • , G. Miceli
  • , L. Montebianco Abenavoli
  • , G. Murgia
  • , P. Naccarato
  • , D. Padula
  • , P. Pattoneri
  • , F. Perego
  • , P. Pesce
  • , S. Piano
  • , M. Pinna
  • , D. Pinto
  • , V. Pretti
  • , G. Pucci
  • , F. Salinaro
  • , A. Salzano
  • , F. Santilli
  • , F. Scarpini
  • , R. Scicali
  • , D. Sirico
  • , P. Suppressa
  • , M. Talia
  • , E. J. Tassone
  • , D. Torres
  • , N. Vazzana
  • , C. R. Vecchio
  • , G. Vidili
  • , F. Vitale
  •  & V. Zaccone

Corresponding author

Correspondence to Francesco Violi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in this study involving human participants were in accordance with the ethical standard of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in this study.

Additional information

Valeria Raparelli and Daniele Pastori contributed equally to this work.

Names of the members of the ARAPACIS Study Group are listed in the Acknowledgement section at the end of the article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Raparelli, V., Pastori, D., Pignataro, S.F. et al. Major adverse cardiovascular events in non-valvular atrial fibrillation with chronic obstructive pulmonary disease: the ARAPACIS study. Intern Emerg Med 13, 651–660 (2018). https://doi.org/10.1007/s11739-018-1835-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11739-018-1835-9

Keywords

Search

Navigation