Abstract 14397: Diabetic Patients Have Significantly Higher Rates of Alzheimer’s Dementia, a Risk That is Attenuated by Treatment Approach
Introduction: Atrial fibrillation (AF) adversely impacts risk of mortality, stroke, heart failure, and dementia. Recently, AF diabetic patients were shown to have much higher rates of silent strokes. Long-term exposure to silent microemboli is a proposed hypothesis explaining the association of AF and dementia. We evaluated the impact of diabetes mellitus (DM) on new onset Alzheimer’s dementia (AD) in AF patients, and if present iwhether ablation attenuates the risk.
Methods: A total of 677 consecutive DM patients who underwent AF ablation were compared to 3442 patients with AF but no ablation and to 3162 patients without AF. The three groups were then compared to nondiabetic patients. Risk of AD was evaluated at 1 year, 3 years, and long-term between the groups.
Results: AF patients (ablation and no ablation groups) had higher rates of hypertension, heart failure, renal failure, and stroke, compared to non-AF patients. Patients with DM had higher rates of dyslipidemia, hypertension, heart failure, renal failure, MI, stroke compared to patients without DM. In all subgroups studied, DM conveyed additional risk of AD compared to patients without DM. The presence of AF without ablation increased this risk long-term in patients with DM (HR=1.57, p=0.04) compared to no AF patients. Ablation of AF attenuates some of the risk of AD with AF in both patients with and without DM (No DM: HR=0.46, p =0.002, DM: HR=0.42, p=0.10) compared to no AF patients.
Conclusions: DM and AF are independent and additive risk factors of AD. AF treatment strategy in similarly matched populations can favorably impact long-term risk in patients with and without DM.
- © 2013 by American Heart Association, Inc.