Impact of preexisting diabetes mellitus on cardiovascular and all-cause mortality in patients with atrial fibrillation: A meta-analysis

Abstract

ObjectiveTo determine the impact of preexisting diabetes mellitus on cardiovascular and all-cause mortality in patients with atrial fibrillation (AF) by conducting a meta-analysis.MethodsPubMed and Embase databases were comprehensively searched for relevant studies publishing until May 19, 2022. Cohort studies or post-hoc analyses of clinical trials that investigated the association of diabetes mellitus with cardiovascular or all-cause mortality in AF patients were included.ResultsA total of 21 studies with 526,136 AF patients were identified. The pooled prevalence of diabetes mellitus in patients with AF was 26%. The summary multivariable-adjusted risk ratio (RR) of all-cause mortality was 1.37 (95% confidence intervals [CIs] 1.23–1.53) for patients with diabetes versus those without diabetes. Moreover, diabetes mellitus was also associated with an increased risk of cardiovascular mortality (RR 1.46; 95% CI 1.34–1.58). Stratified analyses suggested that the impact of diabetes on all-cause and cardiovascular mortality was consistently observed in each named subgroup.ConclusionThe presence of diabetes mellitus in patients with AF is associated with an increased risk of cardiovascular and all-cause mortality, even after adjustment for important confounding factors.

Adverse Events and Clinical Correlates in Asian Patients with Atrial Fibrillation and Diabetes Mellitus: A Report from Asia Pacific Heart Rhythm Society Atrial Fibrillation Registry

“…The DM prevalence of about 25% we found in our Asian population was similar to the 23% showed in the EORP-AF registry conducted in European AF patients [15] and to the pooled prevalence of 26% reported in a recent metanalysis on more than 500,000 AF patients from different geographical areas [16], suggesting that ethnicity plays a marginal…”

“…The DM prevalence of about 25% we found in our Asian population was similar to the 23% showed in the EORP-AF registry conducted in European AF patients [15] and to the pooled prevalence of 26% reported in a recent metanalysis on more than 500,000 AF patients from different geographical areas [16], suggesting that ethnicity plays a marginal role on the differences for DM prevalence in AF patients. Moreover, also the clinical phenotype of AF patients with DM, characterized by advanced age, worse quality of life, and high prevalence of obesity and other cardiovascular risk factors, was consistent to those described in previous studies from European countries, underlying the clinical complexity of these patients, and explaining the higher use of OAC we found [17][18][19].…”

Surgical ablation for atrial fibrillation: impact of Diabetes Mellitus type 2

“…It has been shown that DM type 2 patients treated with sodium-glucose co-transporter inhibitors (SGLT2i) present a lower incidence of AF [ 4 ]. The presence of DM type 2 in patients with AF is associated with an increased risk of cardiovascular and all-cause mortality [ 5 ]. Surgical AF ablation (or “maze procedure’’) is approved in the current guidelines for patients with AF undergoing concomitant cardiac surgery [ 6 ].…”

Surgical ablation for atrial fibrillation: impact of diabetes mellitus

“…It has been shown that DM patients treated with sodium-glucose co-transporter inhibitors (SGLT2i) present with a lower incidence of AF [4]. The presence of DM in patients with AF is associated with an increased risk of cardiovascular and all-cause mortality [5]. Surgical AF ablation (or MAZE procedure) is approved in the current guidelines for patients with AF undergoing concomitant cardiac surgery [6].…”