Amaya García-Fernández1, María Asunción Esteve-Pastor2, Inmaculada Roldán-Rabadán3, Javier Muñiz4,5, Martín Ruiz Ortiz6, Ángel Cequier7, Vicente Bertomeu-Martínez8, Lina Badimón9, Déborah Otero10, Manuel Anguita6, Gregory Y H Lip11,12, Francisco Marín2. 1. Department of Cardiology, Alicante General University Hospital, Sanitary and Biomedical Investigation Institute of Alicante (ISABIAL-FISABIO), Alicante, Spain. 2. Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, Murcia, Spain. 3. Department of Cardiology, University Hospital La Paz, Madrid, Spain. 4. Instituto Universitario de Ciencias de la Salud de la Universidad de A Coruña; Instituto de Investigación Biomédica de A Coruña (INIBIC), CIBERCV, Spain. 5. Instituto de Investigación Biomédica de A Coruña (INIBIC), CIBERCV, A Coruña, Spain. 6. Department of Cardiology, University Hospital Reina Sofia, Cordoba, Spain. 7. Department of Cardiology, University Hospital of Bellvitge, Barcelona, CIBERCV, Spain. 8. Department of Cardiology, University Hospital San Juan de Alicante, Alicante, Spain. 9. Cardiovascular Research Centre(CSIC-ICCC), Barcelona, CIBERCV, Spain. 10. ODDS, S.L., A Coruña, Spain. 11. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK. 12. Faculty of Health, Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Abstract
BACKGROUND: Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events. PURPOSE: To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status. METHODS: AF patients from FANTASIIA registry were included. Baseline characteristics and comorbidities were recorded. After 2-years follow-up, the association between adverse events and DM was evaluated. RESULTS: 1956 patients (mean age 73.8 ± 9.5 years, 56% male) were analyzed; 574 (29.3%) had DM. Diabetic patients had also high prevalence of hypertension (90.6% vs 76.1%; p < .001) or renal disease (21.4% vs 15.9%; p < .001). After median follow-up of 1077 days (IQR 766-1113 days), diabetic patients had high total mortality (16.9%/year vs 11.4%/year; p < .001), cardiovascular mortality (9.1%/year vs 3.9%/year; p < .001) and MACE (12.9%/year vs 6.8%/year; p < .001). DM patients had poor anticoagulation control (time in therapeutic range: 58.52 ± 24.37% vs 62.68 ± 25.31%; p = .002). DM with lower TTR showed higher cardiovascular death and MACE. Multivariate analysis showed an independent association between DM and cardiovascular mortality [HR 1.73 (IC95% 1.07-2.80); p = .024]. CONCLUSION: AF Diabetic patients have higher comorbidities and poorer TTR than nondiabetic patients. Low TTR was associated with adverse events. The risk of cardiovascular outcomes was higher in DM patients, with independent association between DM and mortality risk.
BACKGROUND:Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events. PURPOSE: To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AFpatients regarding DM status. METHODS:AFpatients from FANTASIIA registry were included. Baseline characteristics and comorbidities were recorded. After 2-years follow-up, the association between adverse events and DM was evaluated. RESULTS: 1956 patients (mean age 73.8 ± 9.5 years, 56% male) were analyzed; 574 (29.3%) had DM. Diabeticpatients had also high prevalence of hypertension (90.6% vs 76.1%; p < .001) or renal disease (21.4% vs 15.9%; p < .001). After median follow-up of 1077 days (IQR 766-1113 days), diabeticpatients had high total mortality (16.9%/year vs 11.4%/year; p < .001), cardiovascular mortality (9.1%/year vs 3.9%/year; p < .001) and MACE (12.9%/year vs 6.8%/year; p < .001). DMpatients had poor anticoagulation control (time in therapeutic range: 58.52 ± 24.37% vs 62.68 ± 25.31%; p = .002). DM with lower TTR showed higher cardiovascular death and MACE. Multivariate analysis showed an independent association between DM and cardiovascular mortality [HR 1.73 (IC95% 1.07-2.80); p = .024]. CONCLUSION:AFDiabeticpatients have higher comorbidities and poorer TTR than nondiabetic patients. Low TTR was associated with adverse events. The risk of cardiovascular outcomes was higher in DMpatients, with independent association between DM and mortality risk.
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