Abstract
2 min read<b>Aims.</b> To evaluate the adverse events (and its clinical correlates) in a large prospective cohort of Asian patients with atrial fibrillation (AF) and diabetes mellitus (DM). <b>Material and Methods.</b> We recruited patients with atrial fibrillation (AF) from the Asia-Pacific Heart Rhythm Society (APHRS) AF Registry and included those for whom the diabetic mellitus (DM) status was known. We used Cox-regression analysis to assess the 1-year risk of all-cause death, thromboembolic events, acute coronary syndrome, heart failure and major bleeding. <b>Results.</b> Of 4058 patients (mean age 68.5 ± 11.8 years; 34.4% females) considered for this analysis, 999 (24.6%) had DM (age 71 ± 11 years, 36.4% females). Patients with DM had higher mean CHA<sub>2</sub>DS<sub>2</sub>-VASc (2.3 ± 1.6 vs. 4.0 ± 1.5, <i>p</i> < 0.001) and HAS-BLED (1.3 ± 1.0 vs. 1.7 ± 1.1, <i>p</i> < 0.001) risk scores and were less treated with rhythm control strategies compared to patients without DM (18.7% vs. 22.0%). After 1-year of follow-up, patients with DM had higher incidence of all-cause death (4.9% vs. 2.3%, <i>p</i> < 0.001), cardiovascular death (1.3% vs. 0.4%, <i>p</i> = 0.003), and major bleeding (1.8% vs. 0.9%, <i>p</i> = 0.002) compared to those without DM. On Cox regression analysis, adjusted for age, sex, heart failure, coronary and peripheral artery diseases and previous thromboembolic event, DM was independently associated with a higher risk of all-cause death (HR 1.48, 95% CI 1.00-2.19), cardiovascular death (HR 2.33, 95% CI 1.01-5.40), and major bleeding (HR 1.91, 95% 1.01-3.60). On interaction analysis, the impact of DM in determining the risk of all-cause death was greater in young than in older patients (<i>p</i> int = 0.010). <b>Conclusions.</b> Given the high rates of adverse outcomes in these Asian AF patients with DM, efforts to optimize the management approach of these high-risk patients in a holistic or integrated care approach are needed.
Discussion(0)
No comments yet. Be the first to comment.