Type 1 versus type 2 diabetes and thromboembolic risk in patients with atrial fibrillation:A Danish nationwide cohort study
Autor: | Samuel Z. Goldhaber, Torben Larsen, Gregory Y.H. Lip, Martin Bach Jensen, Bo Christensen, Thure Filskov Overvad, Peter Brønnum Nielsen, Mia Vicki Fangel |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty FITNESS Denmark DIAGNOSES Type 2 diabetes risk stratification 030204 cardiovascular system & hematology OBESITY PARADOX Cohort Studies 03 medical and health sciences MELLITUS 0302 clinical medicine Risk Factors Internal medicine Diabetes mellitus Thromboembolism Atrial Fibrillation medicine cohort study Humans 030212 general & internal medicine Registries VALIDITY Stroke Aged Aged 80 and over Type 1 diabetes diabetes business.industry Hazard ratio Atrial fibrillation Middle Aged thromboembolism medicine.disease stroke Diabetes Mellitus Type 1 ISCHEMIC-STROKE Diabetes Mellitus Type 2 Cohort STRATIFICATION SCHEMES Female Cardiology and Cardiovascular Medicine business Cohort study |
Zdroj: | Fangel, M V, Nielsen, P B, Larsen, T B, Christensen, B, Overvad, T F, Lip, G Y H, Goldhaber, S Z & Jensen, M B 2018, ' Type 1 versus type 2 diabetes and thromboembolic risk in patients with atrial fibrillation : A Danish nationwide cohort study ', International Journal of Cardiology, vol. 268, pp. 137-142 . https://doi.org/10.1016/j.ijcard.2018.05.037 |
Popis: | Background: Atrial fibrillation is a common cause of stroke, and diabetes increases stroke risk. Stroke risk may vary depending on the type of diabetes. We investigated whether type 1 and type 2 diabetes are associated with different risks of thromboembolism among patients with atrial fibrillation.Methods: We used data from Danish nationwide registries to identify patients with a prior diagnosis of diabetes and an incident nonvalvular atrial fibrillation diagnosis in the period of January 1, 2005 to December 31, 2015. Cox regression analysis was used to estimate hazard ratios (HR) for the outcome thromboembolism.Results: The study population included 10,058 patients with a prior diagnosis of diabetes and an incident diagnosis of atrial fibrillation. At three-year follow-up, type 2 diabetes was not associated with a higher risk of thromboembolism compared to type 1 diabetes, with an adjusted HR of 1.15 (95% CI: 0.91-1.44). In an age-stratified analysis, patients aged below 65 years of age had an adjusted HR of 1.97 (95% CI: 1.07-3.61), whereas patients aged 65-74 years or >= 75 years had adjusted HRs of 0.99 (95% CI: 0.67-1.46) and 1.10 (95% CI: 0.80-1.51), respectively.Conclusion: We found no overall credible association between the type of diabetes and risk of thromboembolism in this cohort of non-anticoagulated patients with incident atrial fibrillation. Nonetheless, the subset of patients aged below 65 years of age displayed a higher risk of thromboembolism among patients with type 2 diabetes as compared to patients with type 1 diabetes. (C) 2018 Elsevier B.V. All rights reserved. |
Databáze: | OpenAIRE |
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