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Risk factors for atrial fibrillation in type 2 diabetes: report from the Swedish National Diabetes Register (NDR)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
Univ Gothenburg, Dept Med, Sahlgrenska Univ Hosp, Gothenburg, Sweden..
Univ Gothenburg, Dept Med, Sahlgrenska Univ Hosp, Gothenburg, Sweden..
Univ Gothenburg, Dept Med, Sahlgrenska Univ Hosp, Gothenburg, Sweden..
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2015 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 58, no 10, 2259-2268 p.Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis Atrial fibrillation (AF) is more frequent in patients with diabetes than in the general population. However, characteristics contributing to AF risk in diabetes remain speculative. Methods Observational study of 83,162 patients with type 2 diabetes, aged 30-79 years, with no baseline AF, 17% had history of cardiovascular disease (CVD) and 3.3% history of congestive heart failure (CHF), followed up for development of AF during mean 6.8 years from 2005-2007 to 2012. A subgroup of 67,780 patients without history of CVD or CHF was also analysed. Results Using Cox regression, cardiovascular risk factors associated with risk for AF were updated mean BMI (HR 1.31 per 5 kg/m(2)) or obesity (HR 1.51), updated mean systolic BP (SBP; HR 1.13 per 10 mmHg) or hypertension (HR 1.71), and cumulative microalbuminuria (HR 1.21), p < 0.001 for all analyses. Male sex, increasing age and height were also significant predictors. HRs were 1.76 for a history of CHF and 2.56 for in-study CHF, while 1.32 for history of CVD and 1.38 for in-study CHD (p < 0.001). Among patients without history of CVD or CHF, significant predictors were similarly BMI, SBP, and cumulative microalbuminuria and CHF. The risk of AF differed in the subgroups achieving or not achieving a target BP < 140/85 mmHg. The HRs for AF were (per 10 mmHg increase) 0.88 and 1.24, respectively. Conclusions/interpretation The modifiable risk factors high BP, high BMI and albuminuria were strongly associated with AF in type 2 diabetes. CVD, advancing age and height were also associated with AF in type 2 diabetes.

Place, publisher, year, edition, pages
2015. Vol. 58, no 10, 2259-2268 p.
Keyword [en]
Atrial fibrillation, Cardiovascular diseases, Diabetes mellitus, Myocardial infarction, Registry
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-264820DOI: 10.1007/s00125-015-3666-9ISI: 000361538600008PubMedID: 26088442OAI: oai:DiVA.org:uu-264820DiVA: diva2:865905
Funder
Swedish Association of Local Authorities and Regions
Available from: 2015-10-29 Created: 2015-10-19 Last updated: 2017-12-01Bibliographically approved

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Zethelius, BjörnCederholm, Jan

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