Risk factors for developing atrial fibrillation similar to those seen for other forms of cardiovascular disease
Older age, cardiovascular comorbidities, and renal complications increase the risk for atrial fibrillation (AF) in patients with type 1 diabetes, according to a study published online June 6 in Diabetes Care.
Sara Hallström, from Sahlgrenska University Hospital in Gothenburg, Sweden, and colleagues used data from the Swedish National Diabetes Registry (2001 through 2013) to identify 36,258 individuals with type 1 diabetes. During a median of 9.7 years of follow-up, incident AF was tracked, as were potential risk factors for AF.
The researchers found that 749 individuals developed AF during follow-up. Increased AF risk was associated with
• older age,
• male sex,
• renal complications,
• increased body mass index (BMI),
• higher HbA1c,
• coronary artery disease,
• heart failure, and
• heart valve disease.
The highest risk for AF was associated with age, signs of renal dysfunction with macroalbuminuria, and decreasing estimated glomerular filtration rate. Increased risk was also associated with high blood pressure, severe obesity (BMI >35 kg/m²), and elevated levels of HbA1c (>9.6 percent). However, no associations were seen for hyperlipidemia or smoking.
"Our results imply that risk factors for developing AF in patients with type 1 diabetes are similar to risk factors for other forms of cardiovascular diseases," the authors write.
Risk Factors for Atrial Fibrillation in People With Type 1 Diabetes: An Observational Cohort Study of 36,258 Patients From the Swedish National Diabetes Registry
Sara Hallström, Aldina Pivodic, Annika Rosengren, Arndís F. Ólafsdóttir, Ann-Marie Svensson, Marcus Lind
Diabetes Care 2019 Jun; dc182457. https://doi.org/10.2337/dc18-2457
This study identified variables associated with increased risk of atrial fibrillation in people with type 1 diabetes.
RESEARCH DESIGN AND METHODS
We performed a cohort study of people with type 1 diabetes from the Swedish National Diabetes Registry followed-up between 1 January 2001 and 31 December 2013. Median follow-up was 9.7 years (interquartile range 5.2–13.0). The association between potential risk factors and incident atrial fibrillation was investigated using adjusted Cox regression. To compare the impact of each risk factor, the gradient of risk per 1 SD was estimated.
In this cohort of 36,258 patients with type 1 diabetes, 749 developed atrial fibrillation during follow-up. Older age, male sex, renal complications, increased BMI and HbA1c, coronary artery disease, heart failure, and heart valve disease increased the risk of atrial fibrillation. Age, signs of renal dysfunction with macroalbuminuria and decreasing estimated glomerular filtration rate were associated with the highest gradient of risk for atrial fibrillation. High blood pressure, severe obesity (BMI >35 kg/m2) and elevated levels of HbA1c (>9.6%) were associated with increased risk, but no associations were found with hyperlipidemia or smoking.
The most prominent risk factors for atrial fibrillation in people with type 1 diabetes were older age, cardiovascular comorbidities, and renal complications, while obesity, hypertension, and hyperglycemia had more modest affects.
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