Risk stratification of cardiac arrhythmias and sudden cardiac death in type 2 diabetes mellitus patients receiving insulin therapy: A population-based cohort study



Lee, Sharen, Jeevaratnam, Kamalan, Liu, Tong, Chang, Dong, Chang, Carlin, Wong, Wing Tak, Wong, Ian Chi Kei, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Tse, Gary
(2021) Risk stratification of cardiac arrhythmias and sudden cardiac death in type 2 diabetes mellitus patients receiving insulin therapy: A population-based cohort study. CLINICAL CARDIOLOGY, 44 (11). pp. 1602-1612.

[img] Text
Risk stratification of cardiac arrhythmias and sudden cardiac death in type 2 diabetes mellitus patients receiving insulin t.pdf - Published version

Download (1MB) | Preview

Abstract

<h4>Introduction</h4>Metabolic abnormalities may exacerbate the risk of adverse outcomes in patients with type 2 diabetes mellitus. The present study aims to assess the predictive value of HbA1c and lipid variability on the risks of sudden cardiac death (SCD) and incident atrial fibrillation (AF).<h4>Methods</h4>The retrospective observational study consists of type 2 diabetic patients prescribed with insulin, who went to publicly funded clinics and hospitals in Hong Kong between January 1, 2009 and December 31, 2009. Variability in total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglyceride, and HbA1c were assessed through their SD and coefficient of variation. The primary outcomes were incident (1) ventricular tachycardia/ventricular fibrillation, actual or aborted SCD and (2) AF.<h4>Results</h4>A total of 23 329 patients (mean ± SD age: 64 ± 14 years old; 51% male; mean HbA1c 8.6 ± 1.3%) were included. On multivariable analysis, HbA1c, total cholesterol, LDL-C and triglyceride variability were found to be predictors of SCD (p < .05).<h4>Conclusion</h4>HbA1c and lipid variability were predictive of SCD. Therefore, poor glucose control and variability in lipid parameters in diabetic patients are associated with aborted or actual SCD. These observations suggest the need to re-evaluate the extent of glycemic control required for outcome optimization.

Item Type: Article
Uncontrolled Keywords: cardiac arrhythmias, sudden cardiac death, type 2 diabetes
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 20 Dec 2021 16:54
Last Modified: 18 Jan 2023 21:18
DOI: 10.1002/clc.23728
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3145717