Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study
Background Diabetes is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between patients who have AF with and without diabetes. This study investigated the association of diabetes with AF phenotype and card...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-11-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.021800 |
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| author | Arjola Bano Nicolas Rodondi Jürg H. Beer Giorgio Moschovitis Richard Kobza Stefanie Aeschbacher Oliver Baretella Taulant Muka Christoph Stettler Oscar H. Franco Giulio Conte Christian Sticherling Christine S. Zuern David Conen Michael Kühne Stefan Osswald Laurent Roten Tobias Reichlin |
| author_facet | Arjola Bano Nicolas Rodondi Jürg H. Beer Giorgio Moschovitis Richard Kobza Stefanie Aeschbacher Oliver Baretella Taulant Muka Christoph Stettler Oscar H. Franco Giulio Conte Christian Sticherling Christine S. Zuern David Conen Michael Kühne Stefan Osswald Laurent Roten Tobias Reichlin |
| author_sort | Arjola Bano |
| collection | DOAJ |
| description | Background Diabetes is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between patients who have AF with and without diabetes. This study investigated the association of diabetes with AF phenotype and cardiac and neurological comorbidities in patients with documented AF. Methods and Results Participants in the multicenter Swiss‐AF (Swiss Atrial Fibrillation) study with data on diabetes and AF phenotype were eligible. Primary outcomes were parameters of AF phenotype, including AF type, AF symptoms, and quality of life (assessed by the European Quality of Life‐5 Dimensions Questionnaire [EQ‐5D]). Secondary outcomes were cardiac (ie, history of hypertension, myocardial infarction, and heart failure) and neurological (ie, history of stroke and cognitive impairment) comorbidities. The cross‐sectional association of diabetes with these outcomes was assessed using logistic and linear regression, adjusted for age, sex, and cardiovascular risk factors. We included 2411 patients with AF (27.4% women; median age, 73.6 years). Diabetes was not associated with nonparoxysmal AF (odds ratio [OR], 1.01; 95% CI, 0.81–1.27). Patients with diabetes less often perceived AF symptoms (OR, 0.74; 95% CI, 0.59–0.92) but had worse quality of life (β=−4.54; 95% CI, −6.40 to −2.68) than those without diabetes. Patients with diabetes were more likely to have cardiac (hypertension [OR, 3.04; 95% CI, 2.19–4.22], myocardial infarction [OR, 1.55; 95% CI, 1.18–2.03], heart failure [OR, 1.99; 95% CI, 1.57–2.51]) and neurological (stroke [OR, 1.39, 95% CI, 1.03–1.87], cognitive impairment [OR, 1.75, 95% CI, 1.39–2.21]) comorbidities. Conclusions Patients who have AF with diabetes less often perceive AF symptoms but have worse quality of life and more cardiac and neurological comorbidities than those without diabetes. This raises the question of whether patients with diabetes should be systematically screened for silent AF. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02105844. |
| first_indexed | 2024-04-12T03:45:40Z |
| format | Article |
| id | doaj.art-e11bf37220f0405690ae3f560164c790 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-12T03:45:40Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-e11bf37220f0405690ae3f560164c7902022-12-22T03:49:08ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-11-01102210.1161/JAHA.121.021800Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF StudyArjola Bano0Nicolas Rodondi1Jürg H. Beer2Giorgio Moschovitis3Richard Kobza4Stefanie Aeschbacher5Oliver Baretella6Taulant Muka7Christoph Stettler8Oscar H. Franco9Giulio Conte10Christian Sticherling11Christine S. Zuern12David Conen13Michael Kühne14Stefan Osswald15Laurent Roten16Tobias Reichlin17Department of Cardiology InselspitalBern University HospitalUniversity of Bern SwitzerlandDepartment of General Internal Medicine InselspitalBern University HospitalUniversity of Bern SwitzerlandDepartment of Medicine Cantonal Hospital of Baden and Molecular CardiologyUniversity Hospital of Zürich SwitzerlandDivision of Cardiology Regional Hospital of LuganoEnte Ospedaliero Cantonale (EOC) Lugano SwitzerlandDepartment of Cardiology Luzerner Kantonsspital Luzern SwitzerlandCardiovascular Research Institute BaselUniversity Hospital BaselUniversity of Basel SwitzerlandDepartment of General Internal Medicine InselspitalBern University HospitalUniversity of Bern SwitzerlandInstitute of Social and Preventive Medicine (ISPM) University of Bern SwitzerlandDepartment of Diabetes, Endocrinology, Nutritional Medicine and Metabolism InselspitalBern University HospitalUniversity of Bern SwitzerlandInstitute of Social and Preventive Medicine (ISPM) University of Bern SwitzerlandDivision of Cardiology Cardiocentro Ticino Lugano SwitzerlandCardiovascular Research Institute BaselUniversity Hospital BaselUniversity of Basel SwitzerlandCardiovascular Research Institute BaselUniversity Hospital BaselUniversity of Basel SwitzerlandPopulation Health Research InstituteMcMaster University Hamilton Ontario CanadaCardiovascular Research Institute BaselUniversity Hospital BaselUniversity of Basel SwitzerlandCardiovascular Research Institute BaselUniversity Hospital BaselUniversity of Basel SwitzerlandDepartment of Cardiology InselspitalBern University HospitalUniversity of Bern SwitzerlandDepartment of Cardiology InselspitalBern University HospitalUniversity of Bern SwitzerlandBackground Diabetes is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between patients who have AF with and without diabetes. This study investigated the association of diabetes with AF phenotype and cardiac and neurological comorbidities in patients with documented AF. Methods and Results Participants in the multicenter Swiss‐AF (Swiss Atrial Fibrillation) study with data on diabetes and AF phenotype were eligible. Primary outcomes were parameters of AF phenotype, including AF type, AF symptoms, and quality of life (assessed by the European Quality of Life‐5 Dimensions Questionnaire [EQ‐5D]). Secondary outcomes were cardiac (ie, history of hypertension, myocardial infarction, and heart failure) and neurological (ie, history of stroke and cognitive impairment) comorbidities. The cross‐sectional association of diabetes with these outcomes was assessed using logistic and linear regression, adjusted for age, sex, and cardiovascular risk factors. We included 2411 patients with AF (27.4% women; median age, 73.6 years). Diabetes was not associated with nonparoxysmal AF (odds ratio [OR], 1.01; 95% CI, 0.81–1.27). Patients with diabetes less often perceived AF symptoms (OR, 0.74; 95% CI, 0.59–0.92) but had worse quality of life (β=−4.54; 95% CI, −6.40 to −2.68) than those without diabetes. Patients with diabetes were more likely to have cardiac (hypertension [OR, 3.04; 95% CI, 2.19–4.22], myocardial infarction [OR, 1.55; 95% CI, 1.18–2.03], heart failure [OR, 1.99; 95% CI, 1.57–2.51]) and neurological (stroke [OR, 1.39, 95% CI, 1.03–1.87], cognitive impairment [OR, 1.75, 95% CI, 1.39–2.21]) comorbidities. Conclusions Patients who have AF with diabetes less often perceive AF symptoms but have worse quality of life and more cardiac and neurological comorbidities than those without diabetes. This raises the question of whether patients with diabetes should be systematically screened for silent AF. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02105844.https://www.ahajournals.org/doi/10.1161/JAHA.121.021800atrial fibrillationcardiovascular diseasecognitive impairmentdiabetesquality of life |
| spellingShingle | Arjola Bano Nicolas Rodondi Jürg H. Beer Giorgio Moschovitis Richard Kobza Stefanie Aeschbacher Oliver Baretella Taulant Muka Christoph Stettler Oscar H. Franco Giulio Conte Christian Sticherling Christine S. Zuern David Conen Michael Kühne Stefan Osswald Laurent Roten Tobias Reichlin Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation cardiovascular disease cognitive impairment diabetes quality of life |
| title | Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study |
| title_full | Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study |
| title_fullStr | Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study |
| title_full_unstemmed | Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study |
| title_short | Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study |
| title_sort | association of diabetes with atrial fibrillation phenotype and cardiac and neurological comorbidities insights from the swiss af study |
| topic | atrial fibrillation cardiovascular disease cognitive impairment diabetes quality of life |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.021800 |
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