Incidence of atrial fibrillation, ischaemic heart disease and heart failure in patients with diabetes

Abstract

Background Diabetes has strongly been linked to atrial fibrillation, ischaemic heart disease and heart failure. The epidemiology of these cardiovascular diseases is changing, however, due to changes in prevalence of obesity-related conditions and preventive measures. Recent population studies on incidence of atrial fibrillation, ischaemic heart disease and heart failure in patients with diabetes are needed. Methods A dynamic longitudinal cohort study was performed using primary care databases of the Julius General Practitioners’ Network. Diabetes status was determined at baseline (1 January 2014 or upon entering the cohort) and participants were followed-up for atrial fibrillation, ischaemic heart disease and heart failure until 1 February 2019. Age and sex-specific incidence and incidence rate ratios were calculated. Results Mean follow-up was 4.2 years, 12,168 patients were included in the diabetes group, and 130,143 individuals in the background group. Incidence rate ratios, adjusted for age and sex, were 1.17 (95% confidence interval 1.06–1.30) for atrial fibrillation, 1.66 (1.55–1.83) for ischaemic heart disease, and 2.36 (2.10–2.64) for heart failure. Overall, incidence rate ratios were highest in the younger age categories, converging thereafter. Conclusion There is a clear association between diabetes and incidence of the major chronic progressive heart diseases, notably with heart failure with a more than twice increased risk.

Impaired fasting glucose: a risk factor for atrial fibrillation and heart failure

“…Globally, diabetes is estimated to affect 463 million adults, with one-third to one half being undiagnosed, and with a projected increase in prevalence to 578 million in the year 2030 [ 3 ]. One of the most severe cardiovascular complications associated with diabetes is heart failure [ 4 ], with diabetes increasing the risk for heart failure by up to two times when risk factors are well-controlled and substantially higher if uncontrolled [ 1 , 5 , 6 ]. Furthermore, diabetes has been implicated as a risk factor for incident atrial fibrillation, as well as having a negative impact on prognosis of this disease [ 6 – 10 ].…”

“…One of the most severe cardiovascular complications associated with diabetes is heart failure [ 4 ], with diabetes increasing the risk for heart failure by up to two times when risk factors are well-controlled and substantially higher if uncontrolled [ 1 , 5 , 6 ]. Furthermore, diabetes has been implicated as a risk factor for incident atrial fibrillation, as well as having a negative impact on prognosis of this disease [ 6 – 10 ]. The cardiovascular risk associated with prediabetes is mostly described for cardiovascular mortality, but an association has also been suggested for heart failure [ 11 , 12 ] and atrial fibrillation [ 13 – 16 ].…”

Sex-specific and age-specific incidence of ischaemic heart disease, atrial fibrillation and heart failure in community patients with chronic obstructive pulmonary disease

“…The same cohort was used in a previous study estimating the incidence of CVDs in patients with and without diabetes, with methods similar to those described below. 6 More detailed information on the JGPN is published elsewhere. 7 …”

Heart Failure and Cardiomyopathies: CT and MR from Basics to Advanced Imaging

“…In recent years, many authors have reported an overall stability of HF incidence, most likely attributable to the mean between series with decreased incidence (probably due to the effectiveness of preventive therapies) and series with increased incidence (related to preserved ejection fraction—HFpEF—phenotype) [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”