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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

Bucci, T, Nabrdalik, K, Shantsila, A, Romiti, GF, Teo, WS, Park, HW, Shimizu, W, Tse, HF, Proietti, M, Chao, TF, Lip, GYH and A-PHRSAFR, (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, 13 (5). p. 1274. ISSN 2077-0383

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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.

Item Type: Article
Uncontrolled Keywords: Asians; atrial fibrillation; cardiovascular events; diabetes; major bleedings; 1103 Clinical Sciences
Subjects: R Medicine > R Medicine (General)
Divisions: Nursing & Allied Health
Publisher: MDPI
SWORD Depositor: A Symplectic
Date Deposited: 08 May 2024 13:26
Last Modified: 08 May 2024 13:26
DOI or ID number: 10.3390/jcm13051274
URI: https://researchonline.ljmu.ac.uk/id/eprint/23200
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