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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Association Between Atrial Fibrillation and Diabetes-Related Complications: A Nationwide Cohort Study

Soonil Kwon1, So-Ryoung Lee1,2, Eue-Keun Choi1,2

  • 1Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Diabetes Care
|October 18, 2023
PubMed

Insights

Concurrent atrial fibrillation increases diabetes complication risks, including macrovascular issues, diabetic nephropathy, and foot problems. Patients with both conditions need comprehensive care to mitigate adverse outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Diabetes mellitus is a global health concern associated with numerous complications.
  • Atrial fibrillation is a common arrhythmia that can coexist with diabetes.
  • The combined impact of diabetes and atrial fibrillation on complication risk requires further investigation.

Purpose of the Study:

  • To investigate the association between concurrent atrial fibrillation and diabetes-related complications.
  • To quantify the risk of macrovascular, microvascular, and foot complications in diabetic patients with atrial fibrillation.

Main Methods:

  • Nationwide observational cohort study using Korean National Health Insurance Service data (2009-2012).
  • Propensity score matching (1:5 ratio) to compare patients with and without atrial fibrillation.
  • Outcomes assessed included macrovascular, microvascular (diabetic retinopathy, diabetic nephropathy), and diabetic foot complications.

Main Results:

  • Atrial fibrillation was linked to higher risks of macrovascular complications (HR 1.12), diabetic nephropathy (HR 1.23), and diabetic foot complications (HR 1.13).
  • The risk of diabetic retinopathy was similar between groups (HR 0.99).
  • Patients with atrial fibrillation had a substantially higher risk of diabetic foot amputation (HR 4.12).

Conclusions:

  • Concurrent atrial fibrillation is associated with increased risks of macrovascular, nephropathy, and foot complications in diabetic patients.
  • These findings highlight the need for integrated management strategies for patients with both diabetes and atrial fibrillation.
  • Holistic patient management is crucial to reduce the incidence of adverse outcomes in this population.
Abstract

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