2017
DOI: 10.1371/journal.pone.0170955
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Serum glycated hemoglobin level as a predictor of atrial fibrillation: A systematic review with meta-analysis and meta-regression

Abstract: Background and AimGlycated hemoglobin (HbA1c) is a long-term measure of glucose control. Although recent studies demonstrated a potential association between HbA1c levels and the risk of atrial fibrillation (AF), the results have been inconsistent. The aim of this meta-analysis is to evaluate the utility of HbA1c level in predicting AF.MethodsPubMed and the Cochrane Library databases were searched for relevant studies up to March 2016. Prospective cohort studies and retrospective case-control studies were incl… Show more

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Cited by 50 publications
(28 citation statements)
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“…This suggests that the inclusion of hemorrhagic and undefined stroke subtypes within the stroke outcome assessed may have blunted the statistical significance of the underlying relationship between hyperglycemia and ischemic stroke. This finding is in keeping with previous research that has suggested that diabetes mellitus is primarily a risk factor for ischemic stroke rather than hemorrhagic stroke, and is supported by pathogenic data that links chronic hyperglycemia and ischemic stroke risk factors …”
Section: Discussionsupporting
confidence: 92%
“…This suggests that the inclusion of hemorrhagic and undefined stroke subtypes within the stroke outcome assessed may have blunted the statistical significance of the underlying relationship between hyperglycemia and ischemic stroke. This finding is in keeping with previous research that has suggested that diabetes mellitus is primarily a risk factor for ischemic stroke rather than hemorrhagic stroke, and is supported by pathogenic data that links chronic hyperglycemia and ischemic stroke risk factors …”
Section: Discussionsupporting
confidence: 92%
“…One of the consequences is fibrosis, characterized by increased turnover of the extracellular matrix, producing conduction abnormalities that provide the necessary substrate for arrhythmogenesis . A number of blood biomarkers and electrocardiographic predictors have been found in association with AF onset, development, and recurrence. Of these, galectin‐3 plays a key role in acute and chronic pro‐inflammatory responses and mediates activation of quiescent fibroblasts and synthesis of collagen .…”
Section: Discussionmentioning
confidence: 99%
“…The end result is a pro‐arrhythmic substrate for arrhythmogenesis. As with other disorders, blood markers have been used for risk stratification purposes . More recently, galectin‐3, which is raised in the context of myocardial fibrosis, inflammation, and immune response activation, has emerged as a promising biomarker for risk stratification .…”
Section: Introductionmentioning
confidence: 99%
“…A population‐based case–control study that followed patients with new‐onset atrial fibrillation (NAF) in comparison to a control group without AF for up to 10 years, revealed that, compared to individuals without T2DM, the risk of AF increased with the level of HbA1c. A meta‐analysis of studies with a long follow‐up period did show an increase in the incidence of AF that was proportional to the HbA1c . However, a study of type 2 diabetic patients who had undergone cardiac surgery did not show an association between HbA1c and post‐operative AF, although peri‐operative glycaemic fluctuations appear to increase the risk of post‐operative AF .…”
Section: Incidence and Frequency Of Atrial Fibrillation In The Type 2mentioning
confidence: 97%
“…11 A meta-analysis of studies with a long follow-up period did show an increase in the incidence of AF that was proportional to the HbA1c. 12 However, a study of type 2 diabetic patients who had undergone cardiac surgery did not show an association between HbA1c and postoperative AF, 13 although peri-operative glycaemic fluctuations appear to increase the risk of post-operative AF. 14 In the ACCORD study, aggressive diabetes management with a target HbA1c of less than 6% failed to reduce the incidence of NAF compared to a target of 7.0% to 7.9%.…”
Section: Incidence and Frequency Of Atrial Fibrillation In The Typementioning
confidence: 99%