open access publication

Article, 2024

Adverse Events and Clinical Correlates in Asian Patients with Atrial Fibrillation and Diabetes Mellitus: A Report from Asia Pacific Heart Rhythm Society Atrial Fibrillation Registry

Journal of Clinical Medicine, ISSN 2077-0383, Volume 13, 5, Page 1274, 10.3390/jcm13051274

Contributors

Bucci, Tommaso 0000-0003-2895-6234 [1] [2] [3] Nabrdalik, Katarzyna 0000-0002-0777-8048 [1] [2] [4] Shantsila, Alena 0000-0002-0594-8576 [1] [2] Romiti, Giulio Francesco [1] [2] [3] Teo, Wee Siong [5] Park, Hyung Wook 0000-0002-9630-0467 [6] Shimizu, Wataru 0000-0001-9941-8973 [7] Tse, Hung-Fat Tse 0000-0002-9578-7808 [8] [9] Proietti, Marco 0000-0003-1452-2478 [10] [11] Chao, Tze-Fan (Corresponding author) [12] [13] Lip, Gregory Y. H. (Corresponding author) [1] [2] [14] Investigators, Asia-Pacific Heart Rhythm Society Atrial Fibrillation Registry

Affiliations

  1. [1] Liverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK, knabrdalik@sum.edu.pl, (K.N.);, s.shantsila@liverpool.ac.uk, (A.S.);, giuliofrancesco.romiti@uniroma1.it, (G.F.R.)
  2. [2] University of Liverpool
    3. [NORA names: United Kingdom; Europe, Non-EU; OECD];
  3. [3] Sapienza University of Rome
    4. [NORA names: Italy; Europe, EU; OECD];
  4. [4] Medical University of Silesia
    5. [NORA names: Poland; Europe, EU; OECD];
  5. [5] National Heart Centre Singapore
    6. [NORA names: Singapore; Asia, South];

Abstract

Aims. To evaluate the adverse events (and its clinical correlates) in a large prospective cohort of Asian patients with atrial fibrillation (AF) and diabetes mellitus (DM). Material and Methods. We recruited patients with atrial fibrillation (AF) from the Asia-Pacific Heart Rhythm Society (APHRS) AF Registry and included those for whom the diabetic mellitus (DM) status was known. We used Cox-regression analysis to assess the 1-year risk of all-cause death, thromboembolic events, acute coronary syndrome, heart failure and major bleeding. Results. Of 4058 patients (mean age 68.5 ± 11.8 years; 34.4% females) considered for this analysis, 999 (24.6%) had DM (age 71 ± 11 years, 36.4% females). Patients with DM had higher mean CHA2DS2-VASc (2.3 ± 1.6 vs. 4.0 ± 1.5, p < 0.001) and HAS-BLED (1.3 ± 1.0 vs. 1.7 ± 1.1, p < 0.001) risk scores and were less treated with rhythm control strategies compared to patients without DM (18.7% vs. 22.0%). After 1-year of follow-up, patients with DM had higher incidence of all-cause death (4.9% vs. 2.3%, p < 0.001), cardiovascular death (1.3% vs. 0.4%, p = 0.003), and major bleeding (1.8% vs. 0.9%, p = 0.002) compared to those without DM. On Cox regression analysis, adjusted for age, sex, heart failure, coronary and peripheral artery diseases and previous thromboembolic event, DM was independently associated with a higher risk of all-cause death (HR 1.48, 95% CI 1.00-2.19), cardiovascular death (HR 2.33, 95% CI 1.01-5.40), and major bleeding (HR 1.91, 95% 1.01-3.60). On interaction analysis, the impact of DM in determining the risk of all-cause death was greater in young than in older patients (p int = 0.010). Conclusions. Given the high rates of adverse outcomes in these Asian AF patients with DM, efforts to optimize the management approach of these high-risk patients in a holistic or integrated care approach are needed.

Keywords

AF patients, Asia, Asia Pacific Heart Rhythm Society, Asia-Pacific, Asian AF patients, Asian patients, Atrial, Atrial Fibrillation Registry, CHA, Cox, Cox regression, Cox regression analysis, HAS-BLED, Heart Rhythm Society, acute coronary syndrome, adverse events, adverse outcomes, adversity, age, all-cause death, analysis, approach, artery disease, atrial fibrillation, bleeding, cardiovascular death, care approach, clinic, clinical correlates, cohort, cohort of Asian patients, control strategy, coronary syndrome, correlation, death, diabetes, diabetes mellitus, disease, events, failure, fibrillation, follow-up, heart, heart failure, high risk, high-risk patients, higher incidence, higher incidence of all-cause death, higher risk of all-cause death, impact, impact of DM, incidence of all-cause death, integrated care approach, interaction, interaction analysis, management, management approach, mellitus, older patients, outcomes, patients, peripheral arterial disease, rate, rates of adverse outcomes, registry, regression analysis, reports, rhythm control strategy, risk, risk of all-cause death, risk score, scores, sex, society, status, strategies, syndrome, thromboembolic events

Data Provider: Digital Science

LINKS
-

Matching Records in NORA

SUBJECTS
+

METRICS
+