So-Ryoung Lee1, Eue-Keun Choi2, Tae-Min Rhee1, Hyun-Jung Lee1, Woo-Hyun Lim3, Si-Hyuck Kang4, Kyung-Do Han5, Myung-Jin Cha1, Youngjin Cho4, Il-Young Oh4, Seil Oh1. 1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 2. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: choiek17@snu.ac.kr. 3. Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. 4. Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 5. Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Abstract
BACKGROUND: Atrial fibrillation (AF) is prevalent among type 2 diabetic patients. However, the association between diabetic retinopathy (DR) and AF is controversial. METHODS: We included 40,500 patients with type 2 diabetes (≥40years, mean age 62±11years, 53% men) without AF from the Korean National Insurance Service-National Sample Cohort (2002-2007). Subjects were classified without DR (non-DR, n=30,178), with DR (DR, n=8920), and with proliferative DR (PDR, n=1402). RESULTS: During a mean 5.9-year follow-up, 1261 (3.1%) patients were newly diagnosed as having AF (4.9, 6.0, and 8.3 per 1000 person-years in the non-DR, DR, and PDR groups, respectively). In multivariate Cox proportional hazard models, patients in the DR and PDR groups had a significantly higher risk of AF than those in the non-DR group (DR group: hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.00-1.30; PDR group: HR 1.46, 95% CI 1.13-1.87); p for trend <0.001). The risk of AF increased in patients with DR and end-stage renal disease (ESRD) (HR 2.39, 95% CI 1.31-3.96, p<0.001) and in those with PDR and ESRD (HR 3.59, 95% CI 1.96-5.97, p<0.001) compared to those without DR and ESRD. CONCLUSIONS: The presence and severity of DR was significantly associated with the incidence of AF. Also, the presence of ESRD had an impact on the incidence of AF in patients with DR.
BACKGROUND:Atrial fibrillation (AF) is prevalent among type 2 diabeticpatients. However, the association between diabetic retinopathy (DR) and AF is controversial. METHODS: We included 40,500 patients with type 2 diabetes (≥40years, mean age 62±11years, 53% men) without AF from the Korean National Insurance Service-National Sample Cohort (2002-2007). Subjects were classified without DR (non-DR, n=30,178), with DR (DR, n=8920), and with proliferative DR (PDR, n=1402). RESULTS: During a mean 5.9-year follow-up, 1261 (3.1%) patients were newly diagnosed as having AF (4.9, 6.0, and 8.3 per 1000 person-years in the non-DR, DR, and PDR groups, respectively). In multivariate Cox proportional hazard models, patients in the DR and PDR groups had a significantly higher risk of AF than those in the non-DR group (DR group: hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.00-1.30; PDR group: HR 1.46, 95% CI 1.13-1.87); p for trend <0.001). The risk of AF increased in patients with DR and end-stage renal disease (ESRD) (HR 2.39, 95% CI 1.31-3.96, p<0.001) and in those with PDR and ESRD (HR 3.59, 95% CI 1.96-5.97, p<0.001) compared to those without DR and ESRD. CONCLUSIONS: The presence and severity of DR was significantly associated with the incidence of AF. Also, the presence of ESRD had an impact on the incidence of AF in patients with DR.
Authors: Gen-Min Lin; Laura A Colangelo; Barbara E K Klein; Mary Frances Cotch; Tien Y Wong; Carol Y Cheung; Susan R Heckbert; Alvaro Alonso; Younghoon Kwon; Richard A Kronmal; Donald M Lloyd-Jones; Kiang Liu Journal: Ophthalmol Retina Date: 2020-06-19
Authors: Ji Hyun Lee; Ju Hee Han; Kyung Do Han; Young Min Park; Jun Young Lee; Yong-Gyu Park; Young Bok Lee Journal: Sci Rep Date: 2018-06-14 Impact factor: 4.379