Ding, Wern Yew 
ORCID: 0000-0003-3596-6545, Kotalczyk, Agnieszka, Boriani, Giuseppe, Marin, Francisco, Blomstrom-Lundqvist, Carina, Potpara, Tatjana S, Fauchier, Laurent and Lip, Gregory YH ORCID: 0000-0002-7566-1626
(2022)
Impact of diabetes on the management and outcomes in atrial fibrillation: an analysis from the ESC-EHRA EORP-AF Long-Term General Registry.
EUROPEAN JOURNAL OF INTERNAL MEDICINE, 103.
pp. 41-49.
Abstract
<h4>Background</h4>The prevalence of atrial fibrillation(AF) and diabetes mellitus is rising to epidemic proportions. We aimed to assess the impact of diabetes on the management and outcomes of patients with AF.<h4>Methods</h4>The EORP-AF General Long-Term Registry is a prospective, observational registry from 250 centres across 27 European countries. Outcomes of interest were as follows: i)rhythm control interventions; ii)quality of life; iii)healthcare resource utilisation; and iv)major adverse events.<h4>Results</h4>Of 11,028 patients with AF, the median age was 71 (63-77) years and 2537 (23.0%) had diabetes. Median follow-up was 24 months. Diabetes was related to increased use of anticoagulation but less rhythm control interventions. Using multivariable analysis, at 2-year follow-up, patients with diabetes were associated with greater levels of anxiety (p = 0.038) compared to those without diabetes. Overall, diabetes was associated with worse health during follow-up, as indicated by Health Utility Score and Visual Analogue Scale. Healthcare resource utilisation was greater with diabetes in terms of length of hospital stay (8.1 (±8.2) vs. 6.1 (±6.7) days); cardiology and internal medicine/general practitioner visits; and emergency room admissions. Diabetes was an independent risk factor of major adverse cardiovascular event (MACE; HR 1.26 [95% CI, 1.04-1.52]), all-cause mortality (HR 1.28 [95% CI, 1.08-1.52]), and cardiovascular mortality (HR 1.41 [95% CI, 1.09-1.83]).<h4>Conclusion</h4>In this contemporary AF cohort, diabetes was present in 1 in 4 patients and it served as an independent risk factor for reduced quality of life, greater healthcare resource utilisation and excess MACE, all-cause mortality and cardiovascular mortality. There was increased use of anticoagulation therapy in diabetes but with less rhythm control interventions.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Cohort, Prevalence, Healthcare resource utilisation, Prognosis, MACE, Mortality |
| 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: | 28 Jun 2022 15:08 |
| Last Modified: | 18 Jan 2023 20:56 |
| DOI: | 10.1016/j.ejim.2022.04.026 |
| Open Access URL: | https://doi.org/10.1016/j.ejim.2022.04.026 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3157397 |
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