Association between insulin resistance and risk of atrial fibrillation in non-diabetics

Lee, Yong-Gu; Joo, Sung Yeol; Park, Jung Hwan; Shin, Junho; Lim, Young‐Hyo; Park, Hwan Cheol; Shin, Jinho; Kim, Chun Ki; Park, Jin Kyu

doi:10.1177/2047487320908706

Cited by 35 publications

(36 citation statements)

References 22 publications

(29 reference statements)

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“…In the present issue of the journal, Lee et al studying 8175 patients free of DM and AF at baseline provide a novel insight into the contribution of baseline IR to the long-term risk of incident AF. 6 Over a median follow-up of 12.3 years, 136 individuals developed AF. A homeostasis model assessment of insulin resistance (HOMA-IR) greater than 1.4 conferred an approximately 60% higher risk of developing AF compared with HOMA-IR less than 1.4.…”

Section: Insulin Resistance and Atrial Fibrillationmentioning

confidence: 99%

Editors’ presentation: Focus on diabetes mellitus and diet

Halász

Piepoli

2020

European Journal of Preventive Cardiology

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Section: Insulin Resistance and Atrial Fibrillationmentioning

confidence: 99%

Editors’ presentation: Focus on diabetes mellitus and diet

Halász

Piepoli

2020

European Journal of Preventive Cardiology

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“…Insulin resistance (IR) is a known risk factor for cardiovascular disease (6) that is observed in patients with hypertrophic cardiomyopathy (7). It is associated with atrial remodeling (8) as well as atrial fibrillation (AF) (9). IR may predispose to AF by increasing left atrial size or impairing left ventricular diastolic function in hypertrophic cardiomyopathy (10); however, its role in predicting new-onset POAF after septal myectomy in these patients has not been well investigated.…”

Section: Introductionmentioning

confidence: 99%

Triglyceride–Glucose Index Independently Predicts New-Onset Atrial Fibrillation After Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy Beyond the Traditional Risk Factors

Wei

Zhu

Ren

et al. 2021

Front. Cardiovasc. Med.

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The triglyceride–glucose index is a valuable marker of insulin resistance. However, the predictive value of this index for postoperative atrial fibrillation in patients undergoing septal myectomy remains unclear. A total of 409 patients with hypertrophic obstructive cardiomyopathy who underwent septal myectomy were recruited in this study. The triglyceride–glucose index was calculated for all patients preoperatively. All patients underwent clinical data collection, blood sampling, and standard echocardiographic examinations during hospitalization. The prevalence of postoperative atrial fibrillation was approximately 15% in the present study. Multivariate logistic regression revealed that age (odds ratio [OR]: 1.053, 95% CI: 1.016–1.090, P = 0.004), hypertension (OR: 2.399, 95% CI: 1.228–4.686, P = 0.010), left atrial diameter (OR: 1.101, 95% CI: 1.050–1.155, P < 0.001), and triglyceride–glucose index (OR: 4.218, 95% CI: 2.381–7.473, P < 0.001) were independent risk factors for postoperative atrial fibrillation in patients undergoing septal myectomy. In receiver operating characteristic curve analysis, the triglyceride–glucose index could provide a moderate predictive value for postoperative atrial fibrillation after septal myectomy 0.723 (95% CI: 0.650–0.796, P < 0.001). Moreover, adding the triglyceride–glucose index to conventional risk factor model could numerically but not significantly increase our ability to predict postoperative atrial fibrillation (area under the receiver: 0.742 (0.671–0.814) vs. 0.793 (0.726–0.860), p = 0.065) after septal myectomy. In our retrospective cohort study, the triglyceride–glucose index was identified as an independent predictor of postoperative atrial fibrillation in patients undergoing septal myectomy.

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“…This observational research aimed to study the relationship between potential risk factors as hypoglycemia, FPI, or insulin resistance and the rate incidence of atrial brillation in type 2 diabetes. Therefore, we examined the level of FPI and measured insulin resistance by the homeostatic model of insulin resistance (HOMA-IR) (22) and used continuous glucose and ECG monitoring in parallel for 14 days in patients with type 2 diabetes, who had been treated only with oral hypoglycemic agents.…”

Section: Introductionmentioning

confidence: 99%

Potential triggers of atrial fibrillation in type 2 diabetes mellitus

Mirzarakhimova¹,

Narziev²,

Yakubov³

et al. 2021

Preprint

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Introduction. Atrial fibrillation is an irregular heartbeat that accelerates to form blood clots in the chambers of the heart and leads to stroke, heart failure, and other cardiovascular complications. Diabetes mellitus itself has been identified as a risk factor for atrial fibrillation, but the association between them is unclear. Material and methods. We analyzed 70 patients with type 2 insulin non-dependent diabetes mellitus. All patients were examined in parallel continuous glucose (CGM) and ECG for 14 days. The study population divided into documented atrial fibrillation (AF group, n = 16) and without atrial fibrillation (non-AF group, n = 54) groups. We assessed the relationship between hypoglycemia, fasting plasma insulin, insulin resistance using the homeostatic model assessment (HOMA-IR) equation, and the incidence of atrial fibrillation. Results. We found a total of 46 episodes of documented atrial fibrillation (AF be defined as an arrhythmia lasting ≥ 30 seconds) lasted on the whole 596.9 minute, which was the most significant by the number (2.87 ± 2.05 per patient, p < 0.0001) or the time (31.31 ± 16.57 min per patient, p < 0.0001). We also compared the incident rate of different types of atrial premature complexes between two groups. We found a maximum of 642.6 ± 567.2 single PACs per patient in the AF group, compared to 84.6 ± 87.9, p = 0.002. Despite this, there were significant differences by the following parameters: couplet PACs (p = 0.0015) and triplet or > 3 PACs (p = 0.0007). Over 14 days, a total of 263 hypoglycemic episodes or 5135 min hypoglycemic time were detected, the average number and time of hypoglycemic episodes were 8.0 ± 4.94 per person and 137.0 ± 63.17 min in AF group, and 2.5 ± 4.64 per person (p = 0.0001), 54.5 ± 67.3 min (p = 0.004) in the non-AF group. There was a statistically significant (p < 0.0001) association between FPI and incident AF, more exactly, the mean level of FPI was 31 ± 6.1 mlU/L in the AF group, whereas was 11.3 ± 4.07 in the non-AF group. When we measured the HOMA-IR index by using the homeostasis model, we found significant differences between AF and non-AF groups (11.2 ± 3.88 mmol/l vs. 4.3 ± 1.66 mmol/l, p < 0.0001). Conclusion. The parallel recording of continuous glucose and ECG are necessary to evaluate hypoglycemia-related atrial fibrillation in type 2 diabetes mellitus. Elevated fasting plasma insulin, as well as insulin resistance, are important predictors of atrial fibrillation development, but it needs further studies.

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Association between insulin resistance and risk of atrial fibrillation in non-diabetics

Cited by 35 publications

References 22 publications

Editors’ presentation: Focus on diabetes mellitus and diet

Editors’ presentation: Focus on diabetes mellitus and diet

Triglyceride–Glucose Index Independently Predicts New-Onset Atrial Fibrillation After Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy Beyond the Traditional Risk Factors

Potential triggers of atrial fibrillation in type 2 diabetes mellitus

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