Bucci, Tommaso 
ORCID: 0000-0003-2895-6234, Nabrdalik, Katarzyna, Shantsila, Alena ORCID: 0000-0002-0594-8576, Romiti, Giulio Francesco, Teo, Wee-Siong, Park, Hyung-Wook, Shimizu, Wataru, Tse, Hung-Fat, Proietti, Marco ORCID: 0000-0003-1452-2478, Chao, Tze-Fan et al (show 1 more authors)
(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.
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2024 - Diabetes APHRS.pdf - Open Access published version Download (1MB) | Preview |
Abstract
<jats:p>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.</jats:p>
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Asians, atrial fibrillation, cardiovascular events, diabetes, major bleedings |
| 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: | 29 Feb 2024 11:53 |
| Last Modified: | 10 Apr 2024 20:53 |
| DOI: | 10.3390/jcm13051274 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3179005 |
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