J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://jocmr.elmerjournals.com

Original Article

Volume 17, Number 9, October 2025, pages 529-535

Predictors of a Paroxysm of Atrial Fibrillation Developing in Patients With Exacerbated Chronic Obstructive Pulmonary Disease

↓ Figure 2. The sensitivity and specificity ROC curve of the mathematical model for assessing the probability of A-fib paroxysm recurrence in exacerbated COPD patients. A-fib: atrial fibrillation; COPD: chronic obstructive pulmonary disease; ROC: receiver operating characteristic.

↓ **Table 1.** The Patients’ Clinical Profile
Clinical characteristics	Group I	Group II	P-value
COPD: chronic obstructive pulmonary disease; Me (Q1 - Q3): median and interquartile range.
Number of patients, n	111	458	-
Average age, years, Me (Q1 - Q3)	69.0 (64.0 - 76.0)	66.0 (58.0 - 72.0)	< 0.001
Male, n (%)	79 (71.2%)	337 (73.6%)	0.609
COPD, bronchial obstruction degree, n (%)
Degree I	0 (0.0%)	26 (5.6%)	0.012
Degree II	15 (13.5%)	176 (38.4%)	< 0.001
Degree III	65 (58.6%)	183 (40.0%)	< 0.001
Degree IV	31 (27.9%)	73 (15.9%)	0.003
Arterial hypertension, n (%)	111 (100%)	389 (84.9%)	< 0.001
Chronic coronary disease, n (%)	32 (28.8%)	46 (10.0%)	< 0.001
Chronic heart failure, n (%)	87 (78.3%)	320 (69.9%)	< 0.001
Chronic kidney disease, n (%)	27(24.3%)	98 (21.4%)	0.156
Type 2 diabetes mellitus, n (%)	29 (26.1%)	104 (22.7%)	0.278
Obesity, n (%)	55 (49.5%)	185 (40.3%)	0.021
Charlson Comorbidity Index, points	5 (3 - 6)	3 (2 - 5)	0.004
Forced expiratory volume in one second (FEV₁), %, Me (Q1 - Q3)	34.8% (23.7-57.6%)	41.0% (27.5-65.4%)	0.039
Oxygen saturation (SpO₂) on room air	91.8% (89-95%)	95.2% (91-97%)	0.001

↓ Table 1. The Patients’ Clinical Profile

Clinical characteristics

Group I

Group II

P-value

COPD: chronic obstructive pulmonary disease; Me (Q1 - Q3): median and interquartile range.

Number of patients, n

111

458

Average age, years, Me (Q1 - Q3)

69.0 (64.0 - 76.0)

66.0 (58.0 - 72.0)

< 0.001

Male, n (%)

79 (71.2%)

337 (73.6%)

0.609

COPD, bronchial obstruction degree, n (%)

Degree I

0 (0.0%)

26 (5.6%)

0.012

Degree II

15 (13.5%)

176 (38.4%)

< 0.001

Degree III

65 (58.6%)

183 (40.0%)

< 0.001

Degree IV

31 (27.9%)

73 (15.9%)

0.003

Arterial hypertension, n (%)

111 (100%)

389 (84.9%)

< 0.001

Chronic coronary disease, n (%)

32 (28.8%)

46 (10.0%)

< 0.001

Chronic heart failure, n (%)

87 (78.3%)

320 (69.9%)

< 0.001

Chronic kidney disease, n (%)

27(24.3%)

98 (21.4%)

0.156

Type 2 diabetes mellitus, n (%)

29 (26.1%)

104 (22.7%)

0.278

Obesity, n (%)

55 (49.5%)

185 (40.3%)

0.021

Charlson Comorbidity Index, points

5 (3 - 6)

3 (2 - 5)

0.004

Forced expiratory volume in one second (FEV₁), %, Me (Q1 - Q3)

34.8% (23.7-57.6%)

41.0% (27.5-65.4%)

0.039

Oxygen saturation (SpO₂) on room air

91.8% (89-95%)

95.2% (91-97%)

0.001

↓ **Table 2.** Transthoracic Echocardiography Findings in the Groups Under Review
Attribute	Group I	Group II	P-value
LA: left atrium; LVEDV: left ventricular end-diastolic volume; LVEF: left ventricular ejection fraction; LVESV: left ventricular end-systolic volume; LVMI: left ventricular mass index; RA: right atrium; RV: right ventricle; sPAP: systolic pulmonary artery pressure.
LVEF, %	59.7% (56.7-61.3%)	60.3% (58.2-62.9%)	0.068
LVEDV, mL	112.7 (102; 122)	110.2 (98; 121)	0.480
LVESV, mL	43.6 (38 - 51)	43.1 (34 - 47)	0.149
LVMI, g/m²	95.7 (87.2 - 119.1)	87.9 (73.5 - 110.9)	0.009
LA, mL	60.5 (54.7 - 71.2)	54.6 (46.5 - 62.1)	0.001
RA area, cm²	20.9 (18.5 - 23.7)	15.3 (13.9 - 18.8)	< 0.001
RV, cm	4.2 (3.7 - 4.4)	3.6 (3.6 - 3.8)	0.024
sPAP, mm Hg	45.8 (32 - 51)	34.5 (29 - 44)	0.011

↓ Table 2. Transthoracic Echocardiography Findings in the Groups Under Review

Attribute

Group I

Group II

P-value

LA: left atrium; LVEDV: left ventricular end-diastolic volume; LVEF: left ventricular ejection fraction; LVESV: left ventricular end-systolic volume; LVMI: left ventricular mass index; RA: right atrium; RV: right ventricle; sPAP: systolic pulmonary artery pressure.

LVEF, %

59.7% (56.7-61.3%)

60.3% (58.2-62.9%)

0.068

LVEDV, mL

112.7 (102; 122)

110.2 (98; 121)

0.480

LVESV, mL

43.6 (38 - 51)

43.1 (34 - 47)

0.149

LVMI, g/m²

95.7 (87.2 - 119.1)

87.9 (73.5 - 110.9)

0.009

LA, mL

60.5 (54.7 - 71.2)

54.6 (46.5 - 62.1)

0.001

RA area, cm²

20.9 (18.5 - 23.7)

15.3 (13.9 - 18.8)

< 0.001

RV, cm

4.2 (3.7 - 4.4)

3.6 (3.6 - 3.8)

0.024

sPAP, mm Hg

45.8 (32 - 51)

34.5 (29 - 44)

0.011

↓ **Table 3.** Comprehensive Blood Count in the Groups Under Review
Attribute	Group I	Group II	P-value
ESR: erythrocyte sedimentation rate.
Hematocrit, %	42.7% (37-46%)	43.9% (39-46%)	0.571
Erythrocytes, × 10¹²/L	4.6 (4.1 - 5.2)	4.8 (4.4 - 5.2)	0.085
Hemoglobin, g/L	140 (126 - 149)	143 (130 - 154)	0.128
Leukocytes, × 10⁹/L	12.2 (6.7 - 12.9)	11.3 (7.3 - 12.4)	0.076
Lymphocytes (%)	19.7% (10.1-28.4%)	22.7% (14.4-31.9%)	0.051
Monocytes (%)	5.9% (4.4-8.4%)	6.2% (4.8-8.2%)	0.328
Neutrophils (%)	71.3% (61.7-81.2%)	67.4% (53.7-78.4%)	0.039
Basophils (%)	0.4% (0.2-0.7%)	0.4% (0.2-0.8%)	0.649
Eosinophils (%)	1.0% (0.2-2.2%)	1.1% (0.3-2.6%)	0.345
Platelets, ×10¹²/L	242 (185 - 301)	256 (199 - 315)	0.087
ESR, mm/h	28.4 (7.7 - 35.9)	19.0 (4.2 - 23.1)	< 0.001

↓ Table 3. Comprehensive Blood Count in the Groups Under Review

Attribute

Group I

Group II

P-value

ESR: erythrocyte sedimentation rate.

Hematocrit, %

42.7% (37-46%)

43.9% (39-46%)

0.571

Erythrocytes, × 10¹²/L

4.6 (4.1 - 5.2)

4.8 (4.4 - 5.2)

0.085

Hemoglobin, g/L

140 (126 - 149)

143 (130 - 154)

0.128

Leukocytes, × 10⁹/L

12.2 (6.7 - 12.9)

11.3 (7.3 - 12.4)

0.076

Lymphocytes (%)

19.7% (10.1-28.4%)

22.7% (14.4-31.9%)

0.051

Monocytes (%)

5.9% (4.4-8.4%)

6.2% (4.8-8.2%)

0.328

Neutrophils (%)

71.3% (61.7-81.2%)

67.4% (53.7-78.4%)

0.039

Basophils (%)

0.4% (0.2-0.7%)

0.4% (0.2-0.8%)

0.649

Eosinophils (%)

1.0% (0.2-2.2%)

1.1% (0.3-2.6%)

0.345

Platelets, ×10¹²/L

242 (185 - 301)

256 (199 - 315)

0.087

ESR, mm/h

28.4 (7.7 - 35.9)

19.0 (4.2 - 23.1)

< 0.001

↓ **Table 4.** Predictors of an A-fib Paroxysm Developing in Exacerbated COPD Patients
Indicators	Univariate regression analysis	Multivariate regression analysis
CI: confidence interval; COPD: chronic obstructive pulmonary disease; OR: odds ratio.
Arterial hypertension	3.74	2.78 - 4.19	0.011	3.91	0.90 - 17.01	0.052
Charlson Comorbidity Index above 4 points	1.55	1.40 - 1.71	< 0.001	1.61	1.27 - 2.05	< 0.001
Oxygen saturation (SpO₂) falling below 92%	1.96	1.86 - 2.13	0.025	2.58	0.97 - 6.87	0.067
Right atrial area, cm²	1.39	1.22 - 1.57	< 0.001	1.34	1.16 - 1.56	< 0.001
C-reactive protein, mg/L	1.06	1.04 - 1.08	< 0.001	1.14	1.04 - 1.24	0.004

↓ Table 4. Predictors of an A-fib Paroxysm Developing in Exacerbated COPD Patients

Indicators

Univariate regression analysis

Multivariate regression analysis

Unadjusted OR

95% CI

P-value

Adjusted OR

95% CI

P-value

CI: confidence interval; COPD: chronic obstructive pulmonary disease; OR: odds ratio.

Arterial hypertension

3.74

2.78 - 4.19

0.011

3.91

0.90 - 17.01

0.052

Charlson Comorbidity Index above 4 points

1.55

1.40 - 1.71

< 0.001

1.61

1.27 - 2.05

< 0.001

Oxygen saturation (SpO₂) falling below 92%

1.96

1.86 - 2.13

0.025

2.58

0.97 - 6.87

0.067

Right atrial area, cm²

1.39

1.22 - 1.57

< 0.001

1.34

1.16 - 1.56

< 0.001

C-reactive protein, mg/L

1.06

1.04 - 1.08

< 0.001

1.14

1.04 - 1.24

0.004