New-onset atrial fibrillation in patients with type 2 diabetes was associated with increased risks of ASCVD (HR 1.85; 95% CI 1.59-2.16), heart failure, CKD, and all-cause mortality.
Cohort (n=16,551)
Does new-onset atrial fibrillation increase the risk of ASCVD, heart failure, CKD, and mortality in adults with type 2 diabetes?
New-onset atrial fibrillation in patients with type 2 diabetes significantly increases the risk of subsequent ASCVD, heart failure, CKD, and mortality, highlighting the need for AF prevention strategies.
Effect estimate: HR 1.85 (95% CI 1.59-2.16)
OBJECTIVE: Atrial fibrillation (AF) frequently occurs in patients with type 2 diabetes (T2D); however, the longitudinal associations of new-onset AF with risks of adverse health outcomes in patients with T2D remain unclear. In this study, we aimed to determine the associations of new-onset AF with subsequent risks of atherosclerotic cardiovascular disease (ASCVD), heart failure, chronic kidney disease (CKD), and mortality among patients with T2D. RESEARCH DESIGN AND METHODS: We included 16,551 adults with T2D, who were free of cardiovascular disease (CVD) and CKD at recruitment from the UK Biobank study. Time-varying Cox regression models were used to assess the associations of incident AF with subsequent risks of incident ASCVD, heart failure, CKD, and mortality. RESULTS: Among the patients with T2D, 1,394 developed AF and 15,157 remained free of AF during the follow-up. Over median follow-up of 10.7-11.0 years, we documented 2,872 cases of ASCVD, 852 heart failure, and 1,548 CKD and 1,776 total death (409 CVD deaths). Among patients with T2D, those with incident AF had higher risk of ASCVD (hazard ratio HR 1.85; 95% CI 1.59-2.16), heart failure (HR 4.40; 95% CI 3.67-5.28), CKD (HR 1.68; 95% CI 1.41-2.01), all-cause mortality (HR 2.91; 95% CI 2.53-3.34), and CVD mortality (HR 3.75; 95% CI 2.93-4.80) compared with those without incident AF. CONCLUSIONS: Patients with T2D who developed AF had significantly increased risks of developing subsequent adverse cardiovascular events, CKD, and mortality. Our data underscore the importance of strategies of AF prevention to reduce macro- and microvascular complications in patients with T2D.
Geng et al. (Fri,) conducted a cohort in Type 2 diabetes (n=16,551). New-onset atrial fibrillation vs. No incident atrial fibrillation was evaluated on Atherosclerotic cardiovascular disease (ASCVD) (HR 1.85, 95% CI 1.59-2.16). New-onset atrial fibrillation in patients with type 2 diabetes was associated with increased risks of ASCVD (HR 1.85; 95% CI 1.59-2.16), heart failure, CKD, and all-cause mortality.