Yu-Cheng Hsieh1,2,3,4, Ying-Chieh Liao1,2,3,4, Cheng-Hung Li1,2,3,4, Jiunn-Cherng Lin2,3,4,5, Chi-Jen Weng2,3,4,5, Che-Chen Lin6, Chu-Pin Lo3, Kuo-Ching Huang4, Jin-Long Huang1,2, Ching-Heng Lin6, Jun-Sing Wang2,7,8, Tsu-Juey Wu1,2, Wayne H-H Sheu2,7. 1. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan. 2. Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan. 3. Department of Data Science and Big Data Analytics, Providence University, Taichung, Taiwan. 4. Department of Financial Engineering, Providence University, Taichung, Taiwan. 5. Department of Internal Medicine, Taichung Veterans General Hospital Chiayi Branch, Chiayi, Taiwan. 6. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan. 7. Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 8. Rong Hsing Research Center and PhD Program for Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
Abstract
BACKGROUND: The impact of hypoglycaemic episode (HE) on the risk of ventricular arrhythmia (VA) and sudden cardiac arrest (SCA) remains unclear. We hypothesized that HE increases the risk of both VA and SCA and that glucose-lowering agents causing HE also increase the risk of VA/SCA in patients with type 2 diabetes (T2D). METHODS: Patients aged 20 years or older with newly diagnosed T2D were identified using the Taiwan National Health Insurance Database. HE was defined as the presentation of hypoglycaemic coma or specified/unspecified hypoglycaemia. The control group consisted of T2D patients without HE. The primary outcome was the occurrence of VA (including ventricular tachycardia and fibrillation) and SCA during the defined follow-up periods. A multivariate Cox hazards regression model was used to evaluate the hazard ratio (HR) for VA or SCA. RESULTS: A total of 54 303 patients were screened, with 1037 patients with HE assigned to the HE group and 4148 frequency-matched patients without HE constituting the control group. During a mean follow-up period of 3.3 ± 2.5 years, 29 VA/SCA events occurred. Compared with the control group, HE group had a higher incidence of VA/SCA (adjusted HR: 2.42, P = .04). Patients who had used insulin for glycaemic control showed an increased risk of VA/SCA compared with patients who did not receive insulin (adjusted HR: 3.05, P = .01). CONCLUSIONS: The HEs in patients with T2D increased the risk of VA/SCA, compared with those who did not experience HEs. Use of insulin also independently increased the risk of VA/SCA.
BACKGROUND: The impact of hypoglycaemic episode (HE) on the risk of ventricular arrhythmia (VA) and sudden cardiac arrest (SCA) remains unclear. We hypothesized that HE increases the risk of both VA and SCA and that glucose-lowering agents causing HE also increase the risk of VA/SCA in patients with type 2 diabetes (T2D). METHODS:Patients aged 20 years or older with newly diagnosed T2D were identified using the Taiwan National Health Insurance Database. HE was defined as the presentation of hypoglycaemic coma or specified/unspecified hypoglycaemia. The control group consisted of T2Dpatients without HE. The primary outcome was the occurrence of VA (including ventricular tachycardia and fibrillation) and SCA during the defined follow-up periods. A multivariate Cox hazards regression model was used to evaluate the hazard ratio (HR) for VA or SCA. RESULTS: A total of 54 303 patients were screened, with 1037 patients with HE assigned to the HE group and 4148 frequency-matched patients without HE constituting the control group. During a mean follow-up period of 3.3 ± 2.5 years, 29 VA/SCA events occurred. Compared with the control group, HE group had a higher incidence of VA/SCA (adjusted HR: 2.42, P = .04). Patients who had used insulin for glycaemic control showed an increased risk of VA/SCA compared with patients who did not receive insulin (adjusted HR: 3.05, P = .01). CONCLUSIONS: The HEs in patients with T2D increased the risk of VA/SCA, compared with those who did not experience HEs. Use of insulin also independently increased the risk of VA/SCA.
Authors: Wang Lijing; Ke Sujie; Wang Linxi; Huang Lishan; Qi Liqin; Zhan Zhidong; Wu Kejun; Zhang Mengjun; Liu Xiaoying; Liu Xiaohong; Liu Libin Journal: Front Endocrinol (Lausanne) Date: 2022-06-17 Impact factor: 6.055
Authors: Travis W Murphy; Scott A Cohen; K Leslie Avery; Meenakshi P Balakrishnan; Ramani Balu; Muhammad Abdul Baker Chowdhury; David B Crabb; Karl W Huesgen; Charles W Hwang; Carolina B Maciel; Sarah S Gul; Francis Han; Torben K Becker Journal: Resusc Plus Date: 2020-11-04