Arnaud Bisson1, Alexandre Bodin1, Grégoire Fauchier2, Julien Herbert1,3, Denis Angoulvant1,4, Pierre Henri Ducluzeau2,5, Gregory Y H Lip6,7, Laurent Fauchier8. 1. Service de Cardiologie, Centre Hospitalier Universitaire Et Faculté de Médecine, Université de Tours, Hôpital Trousseau, 37044, Tours, France. 2. Service de Médecine Interne, Unité D'Endocrinologie Diabétologie Et Nutrition, Centre Hospitalier Universitaire Et Faculté de Médecine, Université de Tours, Tours, France. 3. Service D'information Médicale, D'épidémiologie Et D'économie de La Santé, Centre Hospitalier Universitaire Et Faculté de Médecine, Université de Tours, EA7505, Tours, France. 4. EA4245 T2i, Université de Tours, Tours, France. 5. INRAE (Institut National de Recherche Pour L'Agriculture, l'Alimentation Et L'Environnement), Unité Mixte de Recherche Physiologie de La Reproduction Et Des Comportements, 37380, Nouzilly, France. 6. Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK. 7. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. 8. Service de Cardiologie, Centre Hospitalier Universitaire Et Faculté de Médecine, Université de Tours, Hôpital Trousseau, 37044, Tours, France. lfau@univ-tours.fr.
Abstract
BACKGROUND: There remain uncertainties regarding diabetes mellitus and the incidence of atrial fibrillation (AF), in relation to type of diabetes, and the interactions with sex and age. We investigated whether diabetes confers higher relative rates of AF in women compared to men, and whether these sex-differences depend on type of diabetes and age. METHODS: All patients aged ≥ 18 seen in French hospitals in 2013 with at least 5 years of follow-up without a history of AF were identified and categorized by their diabetes status. We calculated overall and age-dependent incidence rates, hazard ratios, and women-to-men ratios for incidence of AF in patients with type 1 and type 2 diabetes (compared to no diabetes). RESULTS: In 2,921,407 patients with no history of AF (55% women), 45,389 had prevalent type 1 diabetes and 345,499 had prevalent type 2 diabetes. The incidence rates (IRs) of AF were higher in type 1 or type 2 diabetic patients than in non-diabetics, and increased with advancing age. Among individuals with diabetes, the absolute rate of AF was higher in men than in women. When comparing individuals with and without diabetes, women had a higher adjusted hazard ratio (HR) of AF than men: adjusted HR 1.32 (95% confidence interval 1.27-1.37) in women vs. 1.12(1.08-1.16) in men for type 1 diabetes, adjusted HR 1.17(1.16-1.19) in women vs. 1.10(1.09-1.12) in men for type 2 diabetes. CONCLUSION: Although men have higher absolute rates for incidence of AF, the relative rates of incident AF associated with diabetes are higher in women than in men for both type 1 and type 2 diabetes.
BACKGROUND: There remain uncertainties regarding diabetes mellitus and the incidence of atrial fibrillation (AF), in relation to type of diabetes, and the interactions with sex and age. We investigated whether diabetes confers higher relative rates of AF in women compared to men, and whether these sex-differences depend on type of diabetes and age. METHODS: All patients aged ≥ 18 seen in French hospitals in 2013 with at least 5 years of follow-up without a history of AF were identified and categorized by their diabetes status. We calculated overall and age-dependent incidence rates, hazard ratios, and women-to-men ratios for incidence of AF in patients with type 1 and type 2 diabetes (compared to no diabetes). RESULTS: In 2,921,407 patients with no history of AF (55% women), 45,389 had prevalent type 1 diabetes and 345,499 had prevalent type 2 diabetes. The incidence rates (IRs) of AF were higher in type 1 or type 2 diabeticpatients than in non-diabetics, and increased with advancing age. Among individuals with diabetes, the absolute rate of AF was higher in men than in women. When comparing individuals with and without diabetes, women had a higher adjusted hazard ratio (HR) of AF than men: adjusted HR 1.32 (95% confidence interval 1.27-1.37) in women vs. 1.12(1.08-1.16) in men for type 1 diabetes, adjusted HR 1.17(1.16-1.19) in women vs. 1.10(1.09-1.12) in men for type 2 diabetes. CONCLUSION: Although men have higher absolute rates for incidence of AF, the relative rates of incident AF associated with diabetes are higher in women than in men for both type 1 and type 2 diabetes.
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