Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study

Abstract Background To examine the incidence of atrial fibrillation in individuals with type 2 diabetes compared with age- and sex-matched controls from the general population and its variation in relation to glycaemic control and renal function. Methods A total of 421,855 patients with type 2 diabe...

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Main Authors: Shilan Seyed Ahmadi, Ann-Marie Svensson, Aldina Pivodic, Annika Rosengren, Marcus Lind
Format: Article
Language:English
Published: BMC 2020-01-01
Series:Cardiovascular Diabetology
Subjects:
Online Access:https://doi.org/10.1186/s12933-019-0983-1
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author Shilan Seyed Ahmadi
Ann-Marie Svensson
Aldina Pivodic
Annika Rosengren
Marcus Lind
author_facet Shilan Seyed Ahmadi
Ann-Marie Svensson
Aldina Pivodic
Annika Rosengren
Marcus Lind
author_sort Shilan Seyed Ahmadi
collection DOAJ
description Abstract Background To examine the incidence of atrial fibrillation in individuals with type 2 diabetes compared with age- and sex-matched controls from the general population and its variation in relation to glycaemic control and renal function. Methods A total of 421,855 patients with type 2 diabetes from the Swedish National Diabetes Registry and 2,131,223 controls from the Swedish Population Registry, matched for age, sex and county, were included and followed from January 1, 2001 to December 31, 2013. Results Overall, 8.9% of individuals with type 2 diabetes and 7.0% of controls were diagnosed with atrial fibrillation during follow-up, unadjusted incidence risk ratio (IRR) 1.35 (95% 1.33–1.36). Women < 55 years old with type 2 diabetes had an IRR of 2.36 (95% CI 2.10–2.66), in relation to controls, whereas the corresponding value for men < 55 years old with type 2 diabetes was IRR 1.78 (95% CI 1.67–1.90). In the fully adjusted Cox regression, the risk of type 2 diabetes on incident atrial fibrillation was 28% greater vs controls, hazard ratio (HR) 1.28 (95% CI 1.26–1.30), p < 0.0001. The excess risk of atrial fibrillation in individuals with type 2 diabetes increased with worsening glycaemic control and renal complications. For individuals with HbA1c ≤ 6.9% (≤ 52 mmol/mol) and normoalbuminuria the excess risk vs controls was still increased, adjusted HR 1.16 (95% CI 1.14–1.19); p < 0.0001. Conclusions Individuals with type 2 diabetes had an overall 35% higher risk of atrial fibrillation compared to age- and sex-matched controls from the general population. The excess risk for atrial fibrillation increased with renal complications or with poor glycaemic control. Individuals with type 2 diabetes with good glycaemic control and normoalbuminuria had slightly increased risk.
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spelling doaj.art-29006aa5346a49d6a9757071220839132022-12-21T19:40:39ZengBMCCardiovascular Diabetology1475-28402020-01-0119111210.1186/s12933-019-0983-1Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort studyShilan Seyed Ahmadi0Ann-Marie Svensson1Aldina Pivodic2Annika Rosengren3Marcus Lind4Department of Molecular and Clinical Medicine, University of GothenburgDepartment of Molecular and Clinical Medicine, University of GothenburgStatistiska KonsultgruppenDepartment of Molecular and Clinical Medicine, University of GothenburgDepartment of Molecular and Clinical Medicine, University of GothenburgAbstract Background To examine the incidence of atrial fibrillation in individuals with type 2 diabetes compared with age- and sex-matched controls from the general population and its variation in relation to glycaemic control and renal function. Methods A total of 421,855 patients with type 2 diabetes from the Swedish National Diabetes Registry and 2,131,223 controls from the Swedish Population Registry, matched for age, sex and county, were included and followed from January 1, 2001 to December 31, 2013. Results Overall, 8.9% of individuals with type 2 diabetes and 7.0% of controls were diagnosed with atrial fibrillation during follow-up, unadjusted incidence risk ratio (IRR) 1.35 (95% 1.33–1.36). Women < 55 years old with type 2 diabetes had an IRR of 2.36 (95% CI 2.10–2.66), in relation to controls, whereas the corresponding value for men < 55 years old with type 2 diabetes was IRR 1.78 (95% CI 1.67–1.90). In the fully adjusted Cox regression, the risk of type 2 diabetes on incident atrial fibrillation was 28% greater vs controls, hazard ratio (HR) 1.28 (95% CI 1.26–1.30), p < 0.0001. The excess risk of atrial fibrillation in individuals with type 2 diabetes increased with worsening glycaemic control and renal complications. For individuals with HbA1c ≤ 6.9% (≤ 52 mmol/mol) and normoalbuminuria the excess risk vs controls was still increased, adjusted HR 1.16 (95% CI 1.14–1.19); p < 0.0001. Conclusions Individuals with type 2 diabetes had an overall 35% higher risk of atrial fibrillation compared to age- and sex-matched controls from the general population. The excess risk for atrial fibrillation increased with renal complications or with poor glycaemic control. Individuals with type 2 diabetes with good glycaemic control and normoalbuminuria had slightly increased risk.https://doi.org/10.1186/s12933-019-0983-1AlbuminuriaAtrial fibrillationGlycaemic controlType 2 diabetes
spellingShingle Shilan Seyed Ahmadi
Ann-Marie Svensson
Aldina Pivodic
Annika Rosengren
Marcus Lind
Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study
Cardiovascular Diabetology
Albuminuria
Atrial fibrillation
Glycaemic control
Type 2 diabetes
title Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study
title_full Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study
title_fullStr Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study
title_full_unstemmed Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study
title_short Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study
title_sort risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function a swedish cohort study
topic Albuminuria
Atrial fibrillation
Glycaemic control
Type 2 diabetes
url https://doi.org/10.1186/s12933-019-0983-1
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