Seung-Hyun Ko1, Yong-Moon Park2, Jae-Seung Yun1, Seon-Ah Cha1, Eue-Keun Choi3, Kyungdo Han4, Eugene Han5, Yong-Ho Lee5, Yu-Bae Ahn6. 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 2. Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA. 3. Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 4. Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of Korea. 5. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 6. Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: ybahn@catholic.ac.kr.
Abstract
AIMS: This study investigated the association between severe hypoglycemia (SH) and new onset atrial fibrillation (AF) and all-cause mortality in adult patients with type 2 diabetes mellitus (T2DM). METHODS: Retrospective data on patients with T2DM aged between 30 and 75years who received healthcare checkups from January 1, 2005 to December 31, 2008 were analyzed using the National Health Insurance Database in Korea. The primary outcome was newly diagnosed non-valvular AF occurring after SH episode using ICD-10 codes. RESULTS: Among 1,509,280 subjects, 10,864 (0.72%) patients had experienced SH events in the three years prior to health examination, and a total of 48,916 (3.24%) first-time AF episodes occurred during the follow-up period of 8.5years. The incidence of AF was significantly higher in the group with SH than the group without SH. After multivariable adjustment, previous SH was a significant risk factor for the development of AF (HR 1.10, 95% CI 1.01-1.19). All-cause mortality was also significantly increased in patients with previous SH events and prior SH with subsequent AF occurrence, compared to patients without SH events. CONCLUSIONS: Prior SH events were associated with a higher risk of new onset AF and all-cause mortality in patients with T2DM.
AIMS: This study investigated the association between severe hypoglycemia (SH) and new onset atrial fibrillation (AF) and all-cause mortality in adult patients with type 2 diabetes mellitus (T2DM). METHODS: Retrospective data on patients with T2DM aged between 30 and 75years who received healthcare checkups from January 1, 2005 to December 31, 2008 were analyzed using the National Health Insurance Database in Korea. The primary outcome was newly diagnosed non-valvular AF occurring after SH episode using ICD-10 codes. RESULTS: Among 1,509,280 subjects, 10,864 (0.72%) patients had experienced SH events in the three years prior to health examination, and a total of 48,916 (3.24%) first-time AF episodes occurred during the follow-up period of 8.5years. The incidence of AF was significantly higher in the group with SH than the group without SH. After multivariable adjustment, previous SH was a significant risk factor for the development of AF (HR 1.10, 95% CI 1.01-1.19). All-cause mortality was also significantly increased in patients with previous SH events and prior SH with subsequent AF occurrence, compared to patients without SH events. CONCLUSIONS: Prior SH events were associated with a higher risk of new onset AF and all-cause mortality in patients with T2DM.
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