Diabetes Res Clin Pract. 2023;206:111020.
Early rhythm control on diabetes-related complications and mortality in patients with type 2 diabetes mellitus and atrial fibrillation.
제1저자 이소령, 최정민, 최의근 · 교신저자 최의근
소속 (6)
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: choiek17@snu.ac.kr.
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea.
- Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Liverpool Center for Cardiovascular Science at the University of Liverpool, Liverpool John Moores University and Liverpool Chest & Heart Hospital, Liverpool, United Kingdom; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Abstract
AIMS We evaluated the impact of early rhythm control (ERC) on diabetes-related complications and mortality in subjects with type 2 diabetes mellitus (T2DM) and atrial fibrillation (AF).
METHODS This observational cohort study based on the Korean National Health Insurance Service claims database from 2009 to 2016, divided newly diagnosed AF patients with T2DM into ERC or usual care groups based on receiving rhythm control treatment within 1 year of AF diagnosis. The primary outcome was ischemic stroke, and the secondary outcomes were macro/microvascular complications, and all-cause death.
RESULTS Among 47,509 subjects (mean age 66.7 ± 10.5 years; 61.8 % men; mean CHA2DS2-VASc score 4.6 ± 1.8; mean follow-up 4.3 ± 2.3 years; mean DM duration 5.6 ± 4.7 years), 23.1 % received ERC, and 76.9 % did not (usual care group). ERC was associated with lower risks of ischemic stroke, macrovascular and microvascular complications, and all-cause death compared to usual care (adjusted hazard ratios [95 % confidence interval]: 0.77 [0.70-0.85], 0.79 [0.73-0.86], 0.86 [0.82-0.90], and 0.92 [0.87-0.98], p < 0.001, <0.001, <0.001, and 0.012, respectively).
CONCLUSIONS Early rhythm control was associated with reduced risks of diabetes-related complications and mortality in subjects with T2DM and AF. Rhythm control within 1 year of AF diagnosis with proper anticoagulation should be considered to prevent adverse outcomes.
Copyright © 2023 Elsevier B.V. All rights reserved.
Keywords
Atrial fibrillationDeathIschemic strokeMicrovascular/macrovascular complicationsType 2 diabetes mellitus
Conflict of interest statement
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
그 밖의 정보
- 출판 형태
- Observational Study, Journal Article
- 저널
- Diabetes research and clinical practice · eISSN 1872-8227
- 전자 출판
- 2023-11-17
- MeSH
- Male · Humans · Middle Aged · Aged · Female · Atrial Fibrillation* / complications / drug therapy · Stroke* / etiology / prevention & control / diagnosis · Diabetes Mellitus, Type 2* / complications · Risk Assessment · Hypertension* / complications · Diabetes Complications* / complications · Ischemic Stroke* / complications · Risk Factors