Incidence of atrial fibrillation in elderly patients with type 2 diabetes mellitus

Abstract

IntroductionThe incidence of atrial fibrillation (AF), a significant risk factor for cardiovascular disease (CVD), is increasing worldwide. Type 2 diabetes mellitus (T2D) and advanced age are recognized as major risk factors for AF, but herein, we evaluated the incidence of AF in elderly patients with T2D and compared the prognosis between these patients with/without AF.Research design and methodsThe Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD2) study is a follow-up cohort study of the JPAD trial, a randomized controlled clinical trial initiated in 2002 in 2535 Japanese patients with T2D, to examine whether low-dose aspirin prevents CVD. After completion of that trial, we followed up the patients until 2019 and evaluated the incidence of AF. We also compared the incidence of cerebral cardiovascular events in elderly patients with T2D with/without AF.ResultsDuring the median follow-up period of 10.9 years, 132 patients developed AF (incidence rate: 5.14/1000 person-years). The adjusted HRs for cerebral cardiovascular events, stroke, coronary artery disease, heart failure, and all-cause death in elderly patients with T2D with versus without AF were 1.65 (95% CI 1.03 to 2.66), 1.54 (95% CI 0.81 to 2.93), 1.96 (95% CI 1.03 to 3.73), 5.17 (95% CI 2.46 to 10.89), and 1.82 (95% CI 1.24 to 2.67), respectively.ConclusionsAnnually, 1 in 200 elderly Japanese patients with T2D are estimated to develop AF. Because elderly patients with T2D with AF are at an elevated risk for CVD, careful follow-up of this patient subgroup is necessary.Trial registration numberNCT00110448.

Sex Differences in the Preventive Effect of Cardiovascular and Metabolic Therapeutics on Dementia

“…A retrospective study found that low-dose aspirin (40 mg/day) is associated with a reduced incidence of AD in patients with type-2 diabetes (T2D) (Chang et al, 2016). Women who used low-dose aspirin tended to have a lower incidence of dementia than non-users, with no differences observed in men (Matsumoto et al, 2020). However, a higher dose of 80 mg/day can potentially increase the risk of AD in patients with T2D, while 40 mg/day showed a protective effect in preventing AD (Chang et al, 2016).…”

Characterization of Cardiac Fat in Atrial Fibrillation Patients Prior to Ablation Treatment

“…The pathophysiology of AF is caused by asynchronous excitation of the atria, leading to irregularities in both the atrial and ventricular contractions [2]. Age [2] and various comorbidities including obesity [3], type 2 diabetes [4] obstructive sleep apnea [5], and alcohol consumption [6] are recognized as risk factors.…”