Abstract 13713: Atrial Fibrillation is Associated with Long-Term Incidence of Diabetes
Background: The aging population has resulted in more patients living with atrial fibrillation(AF). AF is associated with macro- and micro-thromboembolism, microvascular dysfunction, and system inflammation. Organ systems sensitive to the long-term systemic and vascular disease associations of AF, such as the pancrease, will likely develop dysfunction over time. Therefore, we hypothesized that AF will increase the risk of adult onset diabetes mellitus (DM) over time.
Methods: A total of 40,494 (no AF=28,822 [71.2%]; AF=11,672 [28.8%]) consecutive patients from the large ongoing prospective Intermountain Heart Collaborative Study database were evaluated for MD incidence. DM was determined by ICD-9 code250*. Cox hazard regression was utilized to determine the association of AF presence with DM risk (median follow-up: 1465 days).
Results: AF patients were older (68.0±12.6 vs 56.6±16.2 years, p<0.0001), more like to be male (60.3% vs 57.2%, p<0.0001) and have higher rates of hypertension (43.8% vs 36.8%, p<0.0001), renal failure (1.0% vs 0.5%, p<0.0001), stroke history (5.0% vs 3.4%, p<0.0001), and heart failure (25.4% vs 9.8%, p<0.0001). AF patients were more likely to be treated with a statin, ACE/ARB, diuretic, and warfarin. Over the follow-up period, newly diagnosed DM was significantly higher in the AF group compared to the nonAF group (18.3% vs. 13.2%, p<0.00001) with a univariate hazard ratio (HR) of 1.44 (1.37-1.52), p<0.0001 and a multivariate HR of 1.08 (1.02-1.14), p=0.01. Younger patients (<70 years) had the highest risk.
Conclusion: AF is significantly associated with long-term risk of newly diagnosed DM. Although the risk association was attenuated after adjustment by standard cardiac risk factors, in younger patients the findings remained significant. Defining mechanisms of risk should help to reduce DM incidence in patients with AF.
- © 2012 by American Heart Association, Inc.