Associations of New-Onset Atrial Fibrillation With Risks of Cardiovascular Disease, Chronic Kidney Disease, and Mortality Among Patients With Type 2 Diabetes

Author:

Geng Tingting1,Wang Yi1ORCID,Lu Qi2,Zhang Yan-Bo1,Chen Jun-Xiang1,Zhou Yan-Feng1,Wan Zhenzhen2,Guo Kunquan3,Yang Kun3,Liu Liegang2,Liu Gang2ORCID,Pan An1ORCID

Affiliation:

1. 1Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

2. 2Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

3. 3Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China

Abstract

OBJECTIVE Atrial fibrillation (AF) frequently occurs in patients with type 2 diabetes (T2D); however, the longitudinal associations of new-onset AF with risks of adverse health outcomes in patients with T2D remain unclear. In this study, we aimed to determine the associations of new-onset AF with subsequent risks of atherosclerotic cardiovascular disease (ASCVD), heart failure, chronic kidney disease (CKD), and mortality among patients with T2D. RESEARCH DESIGN AND METHODS We included 16,551 adults with T2D, who were free of cardiovascular disease (CVD) and CKD at recruitment from the UK Biobank study. Time-varying Cox regression models were used to assess the associations of incident AF with subsequent risks of incident ASCVD, heart failure, CKD, and mortality. RESULTS Among the patients with T2D, 1,394 developed AF and 15,157 remained free of AF during the follow-up. Over median follow-up of 10.7–11.0 years, we documented 2,872 cases of ASCVD, 852 heart failure, and 1,548 CKD and 1,776 total death (409 CVD deaths). Among patients with T2D, those with incident AF had higher risk of ASCVD (hazard ratio [HR] 1.85; 95% CI 1.59–2.16), heart failure (HR 4.40; 95% CI 3.67–5.28), CKD (HR 1.68; 95% CI 1.41–2.01), all-cause mortality (HR 2.91; 95% CI 2.53–3.34), and CVD mortality (HR 3.75; 95% CI 2.93–4.80) compared with those without incident AF. CONCLUSIONS Patients with T2D who developed AF had significantly increased risks of developing subsequent adverse cardiovascular events, CKD, and mortality. Our data underscore the importance of strategies of AF prevention to reduce macro- and microvascular complications in patients with T2D.

Funder

National Nature Science Foundation of China

China Postdoctoral Science Foundation

Research Funds for the Central Universities

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

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