Log in to MyACC
Brief Episodes of Silent Atrial Fibrillation Were Associated With an Increased Risk of Silent Cerebral Infarct and Stroke in Type 2 Diabetic Patients
Study Questions:
Are diabetics at increased risk of subclinical episodes of atrial fibrillation (AF) and stroke?
Methods:
Four hundred sixty-four patients under the age of 60 years (mean age 52 years) with type 2 diabetes underwent 48-hour Holter monitoring at 3, 6, 9, and 12 months, then annually during a mean follow-up of 37 months. Magnetic resonance imaging (MRI) of the brain was performed at baseline. Patients known to have AF or a prior stroke were excluded, as were patients with comorbidities such as hypertension, coronary artery disease, cardiomyopathy, and sleep apnea. The control group consisted of 240 healthy subjects who were age- and gender-matched.
Results:
Subclinical episodes of AF were significantly more prevalent in the diabetic patients (9%) than in the control group (1.6%). Six percent of AF episodes lasted 10-60 minutes, 70% lasted 1-24 hours, and 24% lasted 1-2 days. Silent cerebral infarcts were found by MRI significantly more often among the diabetic patients with subclinical AF (61%) than among those without AF (29%). Strokes also were more prevalent among the diabetics with than without subclinical AF (17% vs. 6%, respectively). Subclinical AF was an independent predictor of silent cerebral infarction (odds ratio [OR], 4.4) and stroke (OR, 4.6) in the diabetic patients.
Conclusions:
The authors concluded that diabetic patients have a higher prevalence of subclinical AF, and that this is associated with a greater risk of silent cerebral infarction and stroke.
Perspective:
The results suggest that it may be appropriate to screen diabetic patients with an event monitor and to anticoagulate those who are found to have AF.
Keywords: Stroke, Follow-Up Studies, Cerebral Infarction, Diabetes Mellitus, Type 2, Atrial Fibrillation, Magnetic Resonance Imaging
< Back to Listings
