Type 2 Diabetes Mellitus Associated With Modest Increase in Incident AFib in Women

Type 2 diabetes mellitus (T2D) was associated with a modest increase in risk of incident atrial fibrillation (AFib), and was mediated through risk factors such as excess weight gain and a higher prevalence of hypertension, according to a study published on Sept. 12 in the Journal of the American College of Cardiology (JACC).

The study showed "at baseline, 937 (2.7 percent) women had T2D, and when compared with women without T2D, women with T2D had an age adjusted hazard ratio (HR) for new-onset AFib of 1.95 (95 percent confidence interval [CI]: 1.49 to 2.56; p _ 0.0001). In multivariable analyses adjusting for baseline confounders, this HR was substantially attenuated, but baseline T2D remained a significant predictor of incident AFib (HR: 1.37, 95 percent CI: 1.03 to 1.83; p _ 0.03). In time-updated models that adjusted for changes in AFib risk factors and intercurrent cardiovascular events, the HR for T2D was attenuated further and became nonsignificant (HR: 1.14; 95 percent CI: 0.93 to 1.40; p _ 0.20)."

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The study used 34,720 participants from the Women's Health Study who were free of cardiovascular disease and AFib, and were followed for a median of 16.4 years. The authors note that few, if any studies on the association between T2D and AFib have taken into account changes of risk factors over time after the development of T2D. Based on the study's results the authors conclude that "strategies for AFib prevention in diabetic patients should focus on the control of T2D-associted comorbidities, in particular weight maintenance and blood pressure control."

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