Clinical Characteristics and Impact of Diabetes Mellitus on Outcomes in Patients with Nonvalvular Atrial Fibrillation.
- Author:
Bi HUANG
1
;
Yanmin YANG
;
Jun ZHU
;
Yan LIANG
;
Han ZHANG
;
Li TIAN
;
Xinghui SHAO
;
Juan WANG
Author Information
- Publication Type:Original Article
- Keywords: Nonvalvular atrial fibrillation; diabetes mellitus; anticoagulation; outcomes
- MeSH: Aged; Atrial Fibrillation/*etiology; Cause of Death; China; Diabetes Complications/*pathology; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Male; Multivariate Analysis; Proportional Hazards Models; Risk Factors; Treatment Outcome
- From:Yonsei Medical Journal 2015;56(1):62-71
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Studies have shown that diabetes mellitus (DM) is a risk factor for cardiovascular disease, including atrial fibrillation (AF); however, the clinical characteristics and prognostic impact of DM in patients with nonvalvular AF have not been well understood in China. MATERIALS AND METHODS: Included were 1644 consecutive patients with nonvalvular AF. Endpoints included all-cause mortality, cardiovascular mortality, stroke, major bleeding, and combined endpoint events (CEE) during a 1-year follow-up. RESULTS: The prevalence of DM was 16.8% in nonvalvular AF patients. Compared with non-diabetic AF patients, diabetic AF patients were older and tended to coexist with other cardiovascular diseases. Most patients with DM (93.5%) were eligible for anticoagulation, as determined by CHADS2 scores. However, only 11.2% of patients received anticoagulation. During a 1-year follow-up, the all-cause mortality and CEE rate in the DM group were significantly higher than those of the non-DM group, while the incidence of stroke was comparable. After multivariate adjustments, DM was still an independent risk factor for 1-year all-cause mortality [hazard ratio (HR)=1.558; 95% confidence interval (CI) 1.126-2.156; p=0.007], cardiovascular mortality (HR=1.615; 95% CI 1.052-2.479; p=0.028), and CEE (HR=1.523; 95% CI 1.098-2.112; p=0.012), yet not for stroke (HR=1.119; 95% CI 0.724-1.728; p=0.614). CONCLUSION: DM is a common morbidity coexisting with nonvalvular AF and is associated with an increased risk of 1-year all-cause mortality, cardiovascular mortality, and CEE. However, no increased risk of stroke was found during a 1-year follow-up in patients with AF and DM.
