The association between insulin resistance and atrial fibrillation: A cross‐sectional analysis from SPRINT (Systolic Blood Pressure Intervention Trial)

Cho, Monique E.; Craven, Timothy E.; Cheung, Alfred K.; Glasser, Stephen P.; Rahman, Mahboob; Soliman, Elsayed Z.; Stafford, Randall S.; Johnson, Karen C.; Bates, Jeffrey T.; Burgner, Anna; Taylor, Addison A.; Tamariz, Leonardo; Tang, Rocky; Beddhu, Srinivasan

doi:10.1111/jch.13062

Cited by 8 publications

(8 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies have shown a correlation between low high‐density lipoprotein cholesterol and/or high triglycerides and the occurrence of AF in a wide range of ethnic groups, with ages from 20 to 64 years, but not in the elderly . In a population of non‐diabetic patients with essential hypertension, Vyssoulis identified that MS was directly and independently related to the prevalence of AF.…”

Section: Incidence and Frequency Of Atrial Fibrillation In The Type 2mentioning

confidence: 99%

“…Several studies have shown a correlation between low highdensity lipoprotein cholesterol and/or high triglycerides and the occurrence of AF in a wide range of ethnic groups, with ages from 20 to 64 years, 2,20-23 but not in the elderly. 24 In a population of non-diabetic patients with essential hypertension, Vyssoulis identified that MS was directly and independently related to the prevalence of AF. Even more important was the fact that the increasing number of MS components were associated with a gradual increment in the risk of AF, with various components having different hazard ratios.…”

Section: Incidence and Frequency Of Atrial Fibrillation In The Typementioning

confidence: 99%

See 1 more Smart Citation

Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti‐diabetic therapies

Bell

Goncalves

2018

Diabetes Obesity Metabolism

100

View full text Add to dashboard Cite

New-onset atrial fibrillation (NAF) is increased in the type 2 diabetic patient because of the presence of the metaboli syndrome and increased sympathetic activity. This results in inflammation, endothelial dysfunction and myocardial steatosis which, in turn, lead to atrial fibrosis and dilatation. The end result is the development of structural and electrical atrial remodeling. Drugs that lower insulin resistance, particularly pioglitazone, decrease the incidence of NAF while drugs that, through hypoglycaemia, stimulate the sympathetic nervous system, insulin and secretagogues, increase the incidence of NAF. Currently there is no evidence that GLP-1 agonists, SGLT2 inhibitors and DPP-4 inhibitors either accelerate or decelerate the development of NAF.

show abstract

Section: Incidence and Frequency Of Atrial Fibrillation In The Type 2mentioning

confidence: 99%

Section: Incidence and Frequency Of Atrial Fibrillation In The Typementioning

confidence: 99%

Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti‐diabetic therapies

Bell

Goncalves

2018

Diabetes Obesity Metabolism

100

View full text Add to dashboard Cite

show abstract

“…IR is a condition in which cells fail to respond normally to insulin, and characterized by a set of signs comprising obesity, increased blood sugar, dyslipidemia, and elevated blood pressure. IR could be considered as a risk factor for kidney disease and AF and plausible mechanism of both kidney disease and AF [ 30 – 32 ].…”

Section: Discussionmentioning

confidence: 99%

Chronic kidney disease and undiagnosed atrial fibrillation in individuals with diabetes

Heo

Rhee

Waalen

et al. 2020

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background Diabetes is an independent risk factor for atrial fibrillation (AF), which is associated with increases in mortality and morbidity, as well as a diminished quality of life. Renal involvement in diabetes is common, and since chronic kidney disease (CKD) shares several of the same putative mechanisms as AF, it may contribute to its increased risk in individuals with diabetes. The objective of this study is to identify the relationship between CKD and the rates of newly-diagnosed AF in individuals with diabetes taking part in a screening program using a self-applied wearable electrocardiogram (ECG) patch. Materials and methods The study included 608 individuals with a diagnosis of diabetes among 1738 total actively monitored participants in the prospective mHealth Screening to Prevent Strokes (mSToPS) trial. Participants, without a prior diagnosis of AF, wore an ECG patch for 2 weeks, twice, over a 4-months period and followed clinically through claims data for 1 year. Definitions of CKD included ICD-9 or ICD-10 chronic renal failure diagnostic codes, and the Health Profile Database algorithm. Individuals requiring dialysis were excluded from trial enrollment. Results Ninety-six (15.8%) of study participants with diabetes also had a diagnosis of CKD. Over 12 months of follow-up, 19 new cases of AF were detected among the 608 participants. AF was newly diagnosed in 7.3% of participants with CKD and 2.3% in those without (P < 0.05) over 12 months of follow-up. In a univariate Cox proportional hazard regression analysis, the risk of incident AF was 3 times higher in individuals with CKD relative to those without CKD: hazard ratios (HR) 3.106 (95% CI 1.2–7.9). After adjusting for the effect of age, sex, and hypertension, the risk of incident AF was still significantly higher in those with CKD: HR 2.886 (95% CI 1.1–7.5). Conclusion Among individuals with diabetes, CKD significantly increases the risk of incident AF. Identification of AF prior to clinical symptoms through active ECG screening could help to improve the clinical outcomes in individuals with CKD and diabetes.

show abstract

“…It is not only the diagnosis of diabetes mellitus that has an association with AF, but increased fasting glucose also independently predicts the risk of AF. Each increase of 18 mg/dL is linked with a 33% increased risk of AF [25].…”

Section: Obesity and Metabolic Syndromementioning

confidence: 99%

The Role of Cardiovascular and Metabolic Comorbidities in the Link between Atrial Fibrillation and Cognitive Impairment: An Appraisal of Current Scientific Evidence

et al. 2019

View full text Add to dashboard Cite

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice with implications on long-term outcomes. Metabolic disorders including diabetes mellitus and obesity are independent predictors of atrial fibrillation and present therapeutic targets to reduce both the incidence and duration burden of atrial fibrillation. The presence of pericardial fat in direct contact with cardiac structures, as well the subsequent release of proinflammatory cytokines, may play an important role in this connection. Atrial fibrillation is an independent predictor of cognitive impairment and dementia. While clinical stroke is a major contributor, other factors such as cerebral hypoperfusion and microbleeds play important roles. New evidence suggests that atrial fibrillation and cognitive impairment may be downstream events of atrial cardiomyopathy, which may be caused by several factors including metabolic syndrome, obesity, and obstructive sleep apnea. The mechanisms linking these comorbidities to cognitive impairment are not yet fully elucidated. A clearer understanding of the association of AF with dementia and cognitive impairment is imperative. Future studies should focus on the predictors of cognitive impairment among those with AF and aim to understand the potential mechanisms underlying these associations. This would inform strategies for the management of AF aiming to prevent continued cognitive impairment.

show abstract

The association between insulin resistance and atrial fibrillation: A cross‐sectional analysis from SPRINT (Systolic Blood Pressure Intervention Trial)

Cited by 8 publications

References 50 publications

Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti‐diabetic therapies

Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti‐diabetic therapies

Chronic kidney disease and undiagnosed atrial fibrillation in individuals with diabetes

The Role of Cardiovascular and Metabolic Comorbidities in the Link between Atrial Fibrillation and Cognitive Impairment: An Appraisal of Current Scientific Evidence

Contact Info

Product

Resources

About