Type 2 Diabetes, Atrial Fibrillation, and Direct Oral Anticoagulation

Chuang

et al. 2020

Cardiovasc Diabetol

Background: Studies specifically examining the association between glycated hemoglobin A1c (HbA1c) levels and ischemic stroke/systemic thromboembolism (IS/SE) risk in atrial fibrillation (AF) patients are limited. Here, we investigated the association between HbA1c levels and the risk of IS/SE, as well as major bleeding, among AF patients with or without oral anticoagulants (OACs). We also compared the effectiveness and safety of warfarin and direct oral anticoagulants (DOACs) in different HbA1c categories. Methods: We utilized medical data from a multi-center healthcare provider in Taiwan, which included 34,036 AF patients with serum HbA1c data available within 3 months after AF being diagnosed. Patients were divided into seven study groups according to their HbA1c levels: < 5.4%, 5.4%-5.6%,

Section: Comparisons Of Doacs and Warfarin In Different Hba1c Categoriessupporting

confidence: 66%

Glycemic status and risks of thromboembolism and major bleeding in patients with atrial fibrillation

Chuang

et al. 2020

Cardiovasc Diabetol

Cardiovasc electrophysiol

“…Although some subanalyses of phase III clinical studies, 95 registries, and small‐sample prospective trials 96 have reported comparable efficacy and safety of NOACs in patients with or without DM, the original studies were not explicitly designed to examine the effect of DM on clinical outcomes in AF patients treated with NOACs versus warfarin. The impact of DM management on AF anticoagulation outcomes and drug interactions between NOACs and common antidiabetic agents remain areas in need of further study 97 …”

Section: Effect Of Lrfm On Af Management Strategiesmentioning

confidence: 99%

“…The impact of DM management on AF anticoagulation outcomes and drug interactions between NOACs and common antidiabetic agents remain areas in need of further study. 97 The effect of high BP on anticoagulation-associated intracranial hemorrhage or hemorrhagic expansion is variably reported. [98][99][100] For AF patients, higher BP has been associated with an increased risk of thromboembolic complications.…”

Section: Anticoagulationmentioning

confidence: 99%

Lifestyle changes in atrial fibrillation management and intervention

Yang

Chung

2023

Atrial fibrillation (AF) is one of the most common arrhythmias in adults, and its continued rise in the United States is complicated by the increased incidence and prevalence of several AF risk factors, such as obesity, physical inactivity, hypertension, obstructive sleep apnea, diabetes mellitus, coronary artery disease, and alcohol, tobacco, or caffeine use. Lifestyle and risk factor modification has been proposed as an additional pillar of AF therapy, added to rhythm control, rate control, and anticoagulation, to reduce AF burden and risk. Although emerging evidence largely supports the integration of lifestyle and risk factor management in clinical practice, randomized clinical trials investigating the long‐term sustainability and reproducibility of these benefits remain sparse. The purpose of this review is to discuss potentially reversible risk factors on AF, share evidence for the impact on AF by modification of these risk factors, and then provide an overview of the effects of reversing or managing these risk factors on the success of various AF management strategies, such as antithrombotic, rate control, and rhythm control therapies.

“…Diabetes health management strategy based on internet plus graded diagnosis and treatment strategy risks to patients (3). Previous studies have shown that the continuous and stable control of blood glucose (4), blood pressure (5) and blood lipids (6) can significantly reduce the occurrence and development of acute and chronic diabetes complications. The most recent American Diabetes Association (ADA) guidelines suggest that glycosylated hemoglobin (HbA1c) should be controlled below 7.0%, and blood pressure should be controlled below 140/ 90 mmHg (blood pressure of patients with cardiovascular risk factors should be controlled below 130/90 mmHg) (7).…”

Section: Original Articlementioning

confidence: 99%

Diabetes health management strategy based on internet plus graded diagnosis and treatment strategy

Liang¹,

Jiang²,

Huang³

et al. 2020

Ann Palliat Med

Background: Type 2 diabetes (T2D) is a widespread chronic disease with high rates of morbidity and mortality worldwide. Managing risk factors can effectively prevent acute and chronic complications, improve quality of life, and reduce mortality. Therefore, implementation of a diabetes health management strategy is urgently needed. Emerging medical technologies have strengthened communication between patients and clinicians. The establishment and improvement of the graded diagnosis and treatment system has promoted the prevention, treatment, and management of diabetes.