Association between glycemic control assessed by continuous glucose monitoring and stroke in patients with atrial fibrillation and diabetes mellitus

BACKGROUND: Both atrial fibrillation (AF) and diabetes mellitus (DM) are documented risk factors for stroke; however, whether glycemic control is associated with the prevalence of stroke remains unclear in patients with AF and DM. The purpose of this study was to investigate the association between glycemic control assessed by continuous glucose monitoring (CGM) and the risk of stroke. METHODS: In total, 510 AF patients with DM from April 2013 to June 2017 were included. The subcutaneous sensor of CGM was inserted after hospital admission and lasted for 72 consecutive hours. Time in range (TIR), a novel metric derived from CGM, was defined as the time spent in the target range (3.9-10 mmol/L). A logistic regression model was constructed by regarding TIR as a categorical variable and a continuous variable, respectively. RESULTS: The mean age of the 510 enrolled patients was 69.8 years. Patients who had previously suffered from stroke had a markedly lower TIR than those without diagnosed stroke (55.1%±19.0% vs. 64.2%±15.1%, P81% (all P<0.001). Taking TIR as a continuous variable, the adjusted OR was 0.89 95% confidence interval (CI): 0.82-0.95 per 10% increment in TIR. CONCLUSIONS: This study found that better TIR is independently associated with a decreased risk of stroke in patients with AF and DM.