The role of electrocardiography (ECG) in predicting mortality in patients with chronic obstructive pulmonary disease (COPD) has not been sufficiently established. Research question: Is a normal ECG associated with a better prognosis than an abnormal ECG in patients with COPD? ECG parameters were assessed in patients enrolled in the Czech Multicenter Research Database of COPD. We assessed ECGs from baseline (August 2013) until December 31, 2019, or until death. The primary endpoint was 5-year overall survival depending on the ECG findings. A total of 300 subjects were enrolled in the study and 143 died during follow-up. This multicenter noninterventional observational prospective study revealed a significant difference in 5-year overall survival between COPD patients with normal ECGs and those with prognostically significant or other ECG abnormalities (76.8%, 38.2%, and 63.4%, respectively; P < 0.001). Patients with prognostically significant ECG abnormalities had a 2.537-fold greater mortality risk at 5 years than those with normal ECGs. In the COPD setting, patients with normal ECGs had a better prognosis than those with prognostically significant abnormalities suggesting that ECG may be a valuable tool for predicting mortality risk in these patients.

Department of Internal Medicine Cardioangiology University Hospital Hradec Kralove Hradec Kralove Czech Republic

Department of Pneumology Bulovka University Hospital Prague Czech Republic

Department of Pneumology Faculty of Medicine Charles University Motol University Hospital Prague CZ Czechia

Department of Pneumology Hospital Jihlava Jihlava Czech Republic

Department of Pneumology Klaudian Hospital Mlada Boleslav Czech Republic

Department of Pneumology University Hospital Hradec Kralove Sokolska 581 Hradec Kralove 500 05 Czech Republic

Department of Respiratory Diseases University Hospital Brno Brno Czech Republic

EUC Clinic Plzen Plzen Czech Republic

Faculty of Medicine in Hradec Kralove Charles University Simkova 870 Hradec Kralove 500 03 Czech Republic

Institute of Biostatistics and Analyses Masaryk University Brno Brno Czech Republic

Pulmonary Department Ceske Budejovice Hospital Ceske Budejovice Czech Republic

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