Key result
Higher long-term HbA1c variability is linked to ~73% increased new-onset AF risk in T2D.
Why the study?
Does higher long-term glycemic variability increase the risk of new-onset atrial fibrillation in patients with type 2 diabetes mellitus?
Cohort (n=505)
No
Does higher long-term glycemic variability increase the risk of new-onset atrial fibrillation in patients with type 2 diabetes mellitus?
Hazard Ratio: 1.726 (95% CI 1.104–1.83)
p-value: p=0.001
In patients with type 2 diabetes mellitus, higher long-term glycemic variability is an independent predictor of new-onset atrial fibrillation, suggesting that stable glycemic control may be important for arrhythmia prevention.
Glycemic variability was associated with new-onset AF in T2DM; leaves open whether stabilizing HbA1c reduces incidence.
OBJECTIVE: It is well known that patients with type 2 diabetes mellitus (T2DM) have a high risk of atrial fibrillation (AF). The current study was designed to determine the relationship between long-term glycemic variability and incidence of new-onset AF in T2DM patients. METHODS: Between January 2008 and December 2009, we conducted a retrospective cohort study in patients with T2DM referred to our hospital. In 505 consecutive patients without any medical history of AF at baseline, the relationship between hemoglobin A1c (HbA1c) variability and future AF incidence was evaluated, with adjustments for other possible confounding factors. HbA1c variability was determined by standard deviation (SD) and coefficient of variation (CV). RESULTS: Over a median of 6.9-year follow-up period, 48 patients (9.5%) developed incident AF. Multiple cox regression revealed that higher HbA1c-SD (HR: 1.726, 95% CI: 1.104-1.830, p=0.001) or HbA1c-CV (HR: 1.241, 95% CI: 1.029-1.497, p=0.024) remained the remarkable predictor of new-onset AF after adjusting for age, body mass index, left ventricular mass index, and left atrium diameter. Receiver operating curve analysis identified thresholds for HbA1c-SD (0.665%, sensitivity 71.4%, specificity 54.9%) and HbA1c-CV (8.970%, sensitivity 73.8%, specificity 47.1%) to detect new-onset AF development. CONCLUSION: In patients with T2DM, higher HbA1c variability is significantly associated with future AF development.
No takes yet. Share an insight, caveat, or question.
Jun Gu (2017) conducted a cohort in Type 2 diabetes mellitus (n=505). Higher HbA1c variability (HbA1c-SD) vs. Lower HbA1c variability was evaluated on Incidence of new-onset atrial fibrillation (HR 1.726, 95% CI 1.104-1.830, p=0.001). Higher long-term glycemic variability, measured by HbA1c standard deviation, significantly increased the risk of new-onset atrial fibrillation in patients with type 2 diabetes (HR 1.726).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: