Risk of atrial fibrillation in diabetes mellitus: A nationwide cohort study

Pallisgaard, Jannik Langtved; Schjerning, Anne-Marie; Lindhardt, Tommi Bo; Procida, Kristina; Hansen, Morten Lock; Torp‐Pedersen, Christian; Gislason, Gunnar

doi:10.1177/2047487315599892

Cited by 102 publications

(64 citation statements)

References 41 publications

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“…A similar pattern was seen in individuals with type 1 diabetes in a previously published cohort study from Sweden [13]. Additionally, a Danish cohort study reported that the risk of atrial fibrillation in individuals with type 2 diabetes was most pronounced in younger patients [15]. When analyzing the excess risk of atrial fibrillation in relation to renal complications, an increased excess risk of atrial fibrillation was observed with greater albuminuria and eGFR.…”

Section: Discussionsupporting

confidence: 77%

Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study

Ahmadi

Svensson

Pivodic

et al. 2020

Cardiovasc Diabetol

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Background: To examine the incidence of atrial fibrillation in individuals with type 2 diabetes compared with ageand sex-matched controls from the general population and its variation in relation to glycaemic control and renal function. Methods:A total of 421,855 patients with type 2 diabetes from the Swedish National Diabetes Registry and 2,131,223 controls from the Swedish Population Registry, matched for age, sex and county, were included and followed from Results: Overall, 8.9% of individuals with type 2 diabetes and 7.0% of controls were diagnosed with atrial fibrillation during follow-up, unadjusted incidence risk ratio (IRR) 1.35 (95% 1.33-1.36). Women < 55 years old with type 2 diabetes had an IRR of 2.36 (95% CI 2.10-2.66), in relation to controls, whereas the corresponding value for men < 55 years old with type 2 diabetes was IRR 1.78 (95% CI 1.67-1.90). In the fully adjusted Cox regression, the risk of type 2 diabetes on incident atrial fibrillation was 28% greater vs controls, hazard ratio (HR) 1.28 (95% CI 1.26-1.30), p < 0.0001. The excess risk of atrial fibrillation in individuals with type 2 diabetes increased with worsening glycaemic control and renal complications. For individuals with HbA1c ≤ 6.9% (≤ 52 mmol/mol) and normoalbuminuria the excess risk vs controls was still increased, adjusted HR 1.16 (95% CI 1.14-1.19); p < 0.0001. Conclusions:Individuals with type 2 diabetes had an overall 35% higher risk of atrial fibrillation compared to ageand sex-matched controls from the general population. The excess risk for atrial fibrillation increased with renal complications or with poor glycaemic control. Individuals with type 2 diabetes with good glycaemic control and normoalbuminuria had slightly increased risk.

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Section: Discussionsupporting

confidence: 77%

Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study

Ahmadi

Svensson

Pivodic

et al. 2020

Cardiovasc Diabetol

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“…Figure S12 in Appendix) (28, 40, 50, 79, 88, 95). For renal function, three reports were inverse but non-significant, five reports were direct but non-significant, and three reports showed significant direct associations (see Appendix p 11 and Suppl.…”

Section: Resultsmentioning

confidence: 99%

Are cardiovascular risk factors also associated with the incidence of atrial fibrillation?

Allan¹,

Honarbakhsh²,

Casas³

et al. 2017

Thromb Haemost

150

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SummaryEstablished primary prevention strategies of cardiovascular diseases are based on understanding of risk factors, but whether the same risk factors are associated with atrial fibrillation (AF) remains unclear. We conducted a systematic review and field synopsis of the associations of 23 cardiovascular risk factors and incident AF, which included 84 reports based on 28 consented and four electronic health record cohorts of 20,420,175 participants and 576,602 AF events. We identified 3-19 reports per risk factor and heterogeneity in AF definition, quality of reporting, and adjustment. We extracted relative risks (RR) and 95 % confidence intervals [CI] and visualised the number of reports with inverse (RR [CI]<1.00), or direct (RR [CI]>1.00) associations. For hypertension (13/17 reports) and obesity (19/19 reports), there were direct associations with incident AF, as there are for coronary heart disease (CHD). There were inverse associations for non-White ethnicity (5/5 reports, with RR from 0.35 to 0.84 [0.82–0.85]), total cholesterol (4/13 reports from 0.76 [0.59–0.98] to 0.94 [0.90–0.97]; 8/13 reports with non-significant inverse associations), and diastolic blood pressure (2/11 reports from 0.87 [0.78–0.96] to 0.92 [0.85–0.99]; 5/11 reports with non-significant inverse associations), and direct associations for taller height (7/10 reports from 1.03 [1.02–1.05] to 1.92 [1.38–2.67]), which are in the opposite direction of known associations with CHD. A systematic evaluation of the available evidence suggests similarities as well as important differences in the risk factors for incidence of AF as compared with other cardiovascular diseases, which has implications for the primary prevention strategies for atrial fibrillation.

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“…Moreover, some antihypertensives, such as β‐blockers and calcium channel blockers, may be protective against AF, and thereby attenuate the association between hypertension and AF. Ideal FBG may also be associated with the reduced risk of AF, perhaps reflecting the contribution of diabetes to AF . Our results indicate that ideal FBG significantly reduces the prevalence of AF but not in individuals over 60 years of age.…”

Section: Discussionmentioning

confidence: 63%

“…Ideal FBG may also be associated with the reduced risk of AF, perhaps reflecting the contribution of diabetes to AF. 31 Our results indicate that ideal FBG significantly reduces the prevalence of AF but not in individuals over 60 years of age. This may be explained by the fact that employees of the oilfield accounted for a large proportion of the population in the present study, and these employees tended to be younger.…”

Section: Factorsmentioning

confidence: 57%

Association between modifiable lifestyle and the prevalence of atrial fibrillation in a Chinese population: Based on the cardiovascular health score

Yang

Chen

Gao

et al. 2017

Clinical Cardiology

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Risk of atrial fibrillation in diabetes mellitus: A nationwide cohort study

Cited by 102 publications

References 41 publications

Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study

Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study

Are cardiovascular risk factors also associated with the incidence of atrial fibrillation?

Association between modifiable lifestyle and the prevalence of atrial fibrillation in a Chinese population: Based on the cardiovascular health score

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