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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 |
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| 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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