TY - JOUR
T1 - Impact of diabetes on the management and outcomes in atrial fibrillation
T2 - an analysis from the ESC-EHRA EORP-AF Long-Term General Registry
AU - Ding, Wern Yew
AU - Kotalczyk, Agnieszka
AU - Boriani, Giuseppe
AU - Marin, Francisco
AU - Blomström-Lundqvist, Carina
AU - Potpara, Tatjana S.
AU - Fauchier, Laurent
AU - Lip, Gregory Y. H.
AU - ESC-EHRA EORP-AF Long-Term General Registry Investigators
A2 - Joensen, Albert Marni
A2 - Gammelmark, Anders
A2 - Rasmussen, Lars Hvilsted
A2 - Danstrup-Dinesen, Pia
A2 - Riahi, Sam
A2 - Venø, Stine Krogh
A2 - Sørensen, Bodil Ginnerup
A2 - Korsgaard, Anne Marie
A2 - Andersen , Karen Petrea
A2 - Hellum, Camilla Fragtrup
N1 - Copyright © 2022. Published by Elsevier B.V.
PY - 2022/9
Y1 - 2022/9
N2 - BACKGROUND: 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.METHODS: 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.RESULTS: 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]).CONCLUSION: 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.
AB - BACKGROUND: 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.METHODS: 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.RESULTS: 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]).CONCLUSION: 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.
KW - Cohort
KW - Healthcare resource utilisation
KW - MACE
KW - Mortality
KW - Prevalence
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85129918095&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2022.04.026
DO - 10.1016/j.ejim.2022.04.026
M3 - Journal article
C2 - 35527179
SN - 0953-6205
SP - 41
EP - 49
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
ER -