Impact of diabetes on the management and outcomes in atrial fibrillation: an analysis from the ESC-EHRA EORP-AF Long-Term General Registry

著者: Wern Yew Ding, Agnieszka Kotalczyk, Giuseppe Boriani, Francisco Marı́n, Carina Blomström‐Lundqvist, Tatjana Potpara, Laurent Fauchier, Gregory Y.H. Lip, Giuseppe Boriani, G Y H Lip, L. Tavazzi, Aldo P. Maggioni, G.-A. Dan, Tatjana Potpara, Michael Näbauer, Francisco Marı́n, Zbigniew Kalarus, Artan Goda, Georges H. Mairesse, Tchavdar Shalganov, Loizos Antoniades, Miloš Táborský, S. Riahi, Piibe Muda, I. García Bolao, Olivier Piot, Michael Näbauer, K. Etsadashvili, E. Simantirakis, Moti Haim, Amirhossein Azhari, Jamshid Najafian, Massimo Santini, Erkin М Мirrakhimov, K a Kulzida, Andrejs Ērglis, L. Poposka, M Burg, Harry J. Crijns, Ö. Erküner, Dan Atar, Radosław Lenarczyk, Mário Oliveira, D. Shah, G.-A. Dan, E. Serdechnaya, Tatjana Potpara, E. Diker, G Y H Lip, D. Lane, E Zëra, U. Ekmekçiu, Vilma Paparisto, Mihal Tase, H. Gjergo, J Dragoti, Artan Goda, M Ciutea, N. Ahadi, Z. el Husseini, M. Raepers, J. Leroy, P Haushan, A. Jourdan, Caroline Lepièce, L. Desteghe, J. Vijgen, Pieter Koopman, G. Van Genechten, Hein Heidbüchel, Tim Boussy, M De Coninck, Hannelore Van Eeckhoutte, N Bouckaert, Alain Friart, J. Boreux, C Arend, P. Evrard, L Stefan, E Hoffer, J. Herzet, M Massoz, C. Celentano, Muriel Sprynger, L. Pierard, P Mélon, B. Van Hauwaert, C. Kuppens, Dirk Faes, Dirk van Lier, A. Van Dorpe, A. Gerardy, O. Deceuninck, Olivier Xhaët, Fabien Dormal, Elisabeth Ballant, D. Blommaert, D. Yakova, Mihail Hristov, T Yncheva, N. Stancheva, S. Tisheva, Mariya Tokmakova, F. Nikolov, D Gencheva, Tchavdar Shalganov, B. Kunev, M. Stoyanov, D. Marchov, V. Gelev, Vassil Traykov, Аntoniya Kisheva, H. Tsvyatkov, R Shtereva, S. Bakalska-Georgieva, S Slavcheva, Yoto Yotov, Milena Kubíčková, A Marni Joensen, Anders Gammelmark, Lars Hvilsted Rasmussen, P. Dinesen, S. Riahi, Stine Krogh Venø, B. Sorensen, A. Korsgaard, Karl Andersen, Camilla Fragtrup Hellum, A. Svenningsen, Ole Nyvad, P Wiggers, O. May, Annemarie Aarup, B Graversen, L. Jensen, Mikkel Porsborg Andersen, M Svejgaard, Sarah Vester, S. Hansen, Vibeke Lynggaard, M Ciudad, R. Vettus, Piibe Muda, Ana Maestre, S. Castaño, S. Cheggour, J Poulard, V. Mouquet, S. Leparrée, J. Bouet, Julien Taı̈eb, A. Doucy, H. Duquenne, A. Furber, Jean‐Marc Dupuis, J Rautureau, Maria Àngels Font, P. Damiano, M Lacrimini, J. Abalea, S Boismal, T. Menez, Jacques Mansourati, Grégoire Rangé, H. Gorka, C. Laure, C. Vassalière, N. Elbaz, Nicolas Lellouche, K. Djouadi, F. Roubille, Denise Dietz, J. Davy, M Granier, Pierre Winum, C Leperchois-Jacquey, M. Granier, E. Marijon, J. Le Heuzey, J. Fedida, Carole Maupain, Caroline Himbert, E. Gandjbakhch, Françoise Hidden‐Lucet, Guillaume Duthoit, Nicolas Badenco, Thomas Chastre, X. Waintraub, M Oudihat, Jordan L. Lacoste, Christoph Stephan, Hugues Bader, N. Delarche, L. Giry, D Arnaud, C. Lopez, F Boury, I. Brunello, Michael Lefevre, R. Mingam, Michel Haı̈ssaguerre, M. Le Bidan, Dominique Pavin, V. Le Moal, Christophe Leclercq, Olivier Piot, T Beitar, I. Martel, Anita N. Schmid, N. Sadki, C. Romeyer-Bouchard, Alessandro Costa, I. Arnault, Michael Boyer, C. Piat, N Lozance, S. Nastevska, A. Doneva, B. Fortomaroska Milevska, B. Sheshoski, K Petroska, N Taneska, N. Bakrecheski, K Lazarovska, Svetlana Jovevska, V Ristovski, A. Antovski, Elena Lazarova, I. Kotlar, J. Taleski, L. Poposka, Saško Kedev, N Zlatanovik, S Jordanova, T. Bajraktarova Proseva, S Doncovska, D Maisuradze, A Esakia, E Sagirashvili, K. Lartsuliani, N Natelashvili, N Gumberidze, R. Gvenetadze, K. Etsadashvili, N Gotonelia, N Kuridze, Giorgi Papiashvili, I Menabde, S. Glöggler, A. Napp, Corinna Lebherz, H. Romero, Karl-Heinz Schmitz, Marc Moritz Berger, Matthias Daniel Zink, S Köster, J Sachse, E. Vonderhagen, G Soiron, Karl Mischke, R Reith, Matthias Schneider, Werner Rieker, D. Boscher, A. Taschareck, Abigail J. Beer, D Oster, Oliver Ritter, Jan Adamczewski, S. Walter, A. Frommhold, E. Luckner, Jannik Richter, M Schellner, S. Landgraf, S. Bartholome, Ralph Naumann, J Schoeler, D Westermeier, F. William, Kenneth Wilhelm, M Maerkl, R. Oekinghaus, M Denart, M Kriete, Ulrich Tebbe, T. Scheibner, Michael P. Gruber, A. Gerlach, C Beckendorf, Lars Anneken, M. Arnold, S. Lengerer, Z. Bal, C. Uecker, H. Förtsch, S. Fechner, V. Mages, Eimo Martens, Heiko Methe, Thomas Schmidt, B. Schaeffer, Boris Hoffmann, J. Moser, K. Heitmann, Stephan Willems, Stephan Willems, C. Klaus, I.R. Lange, Monika Durak, Emre Cem Esen, F. Mibach, H. Mibach, A Utech, M. Gabelmann, Ralf Stumm, V Ländle, C. Gärtner, C Goerg, N. Kaul, Simon Messer, David Burkhardt, Christian Sander, R Orthen, S Kaes, Anselm T. Bäumer, F. Dodos, Andreas S. Barth, G. Schaeffer, Jan Gaertner, J. Winkler, Andreas Fahrig, J Aring, I. Wenzel, Sabine Steiner, A Kliesch, Ewa Maria Kratz, Klaus-Dieter Winter, P. Schneider, A. Haag, I. Mutscher, Ralph Bosch, Jens Taggeselle, S. Meixner, A. Schnabel, A. Shamalla, Holger Hotz, A. Korinth, C. Rheinert, G. Mehltretter, B Schön, Norbert Schön, A Starflinger, E Englmann, G. Baytok, T. Laschinger, Guido Ritscher, A. Gerth, D. Dechering, Lars Eckardt, M. Kuhlmann, N Proskynitopoulos, J Brunn, K Foth, C. Axthelm, H. Hohensee, K Eberhard, S. Turbanisch, N. Hassler, A. Koestler, G. Stenzel, D. Kschiwan, M. Schwefer, S Neiner, Stefan Hettwer, M Haeussler-Schuchardt, Ralf Degenhardt, S Sennhenn, Sabine Steiner, Matthias Brendel, Albrecht Stoehr, W. Widjaja, S. Loehndorf, A. Logemann, J Hoskamp, J. Grundt, M. Block, R. Ulrych, A. Reithmeier, Vasilios Panagopoulos, C Martignani, D. Bernucci, E. Fantecchi, I. Diemberger, Matteo Ziacchi, M. Biffi, Paolo Cimaglia, J Frisoni, Giuseppe Boriani, I. Giannini, S. Boni, Stefano Fumagalli, Simone Pupo, Antonio Di Chiara, P. Mirone, E. Fantecchi, Giuseppe Boriani, Francesca Pesce, Carmine Zoccali, Vincenzo Livio Malavasi, A Mussagaliyeva, B. Ahyt, Z. Salihova, K Koshum-Bayeva, Alina Kerimkulova, A. 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Serdechnaya, O Zavyalova, T. Novikova, I. Riabaia, S. A. Zhigalov, E. Drozdova, I. Luchkina, Y Monogarova, D. Hegya, L. Rodionova, L. Rodionova, В. А. Невзорова, I. Soldatova, O Lusanova, Aleksandra Arandjelovic, D. Toncev, L Vukmirovic, Miša Radisavljević, M. Milanov, Nikola Šekularac, Marija Zdravković, Saša Hinić, Siniša Dimković, T. Acimovic, J. Saric, S. Radovanović, Aleksandar Kocijančić, Biljana Obrenović-Kirćanski, D. Kalimanovska Ostric, A. Kocijancic, Ivan Jovanović, Ivana Petrović, Marija Polovina, M. Vukicevic, Miloje Tomašević, Nataša Mujović, N. Radivojevic, Olga Petrović, S Aleksandric, V Kovacevic, Z Mijatović, Branislava Ivanović, V. Kovacevic, Tatjana Potpara, Arsen Ristić, B. Vujisic-Tesic, Milan Nedeljković, A. Karadzic, B. Vujisic-Tesic, M. Prodanovic, M. Zlatar, Milika Ašanin, B Bisenic, V Vasić, Z. Popovic, D Djikic, M. Sipic, Velimir Perić, Božidar Dejanović, Nikola Milošević, S. Backovic, A. Stevanovic, Anita Andric, B. 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Brockway, William Milligan, J. Sobolewska, James Muir, L. Tuckis, L Winstanley, Pradeep Jacob, S Kaye, L Morby, A. Jan, T. Sewell, Christopher J. Boos, B. Wadams, Constantin Cope, P. Jefferey, Noah Andrews, Allyson K. Getty, Anne Suttling, C. Turner, Kathleen Hudson, R. Marshall Austin, S Howe, Rabia Iqbal, N. Gandhi, K Brophy, P. Mirza, E Willard, S Collins, Ntokozo Ndlovu, E. Subkovas, V. Karthikeyan, L. Waggett, Amanda Wood, A Bolger, J. Stockport, L. Evans, Ece Harman, Jennifer Starling, L. Williams, V. Saul, Michael S. Sinha, L. Bell, S. Tudgay, S. Kemp, J. Brown, Lars Frost, T Ingram, Anita M. Loughlin, Casey Adams, M. Adams, F Hurford, C. Owen, Chris Miller, Denise Donaldson, H. Tivenan, H. Button, A Nasser, O. Jhagra, B Stidolph, C Brown, Churchill Livingstone, M. Duffy, P Madgwick, P. Roberts, Elizabeth Greenwood, L Fletcher, M. Beveridge, S Earles, David J. McKenzie, D. Beacock, Mark Dayer, Mike Seddon, D Greenwell, F Luxton, F Venn, Harold Mills, J Rewbury, Karen James, K Roberts, Louise Tonks, D Felmeden, W. Taggu, A Summerhayes, David M. Hughes, J Sutton, L Felmeden, Mamur Khan, E Walker, L Norris, L O’Donohoe, Abdul Mozid, Harvey Dymond, Hannah Lloyd-Jones, G. Saunders, David N. Simmons, D. R. Coles, Donna Cotterill, S Beech, Stephen Kidd, Benjamin Wrigley, Sanjiv Petkar, Andrew Smallwood, Russell Jones, E Radford, Sarah Milgate, Stella Metherell, V Cottam, C Buckley, A Broadley, D Wood, John D. Allison, Kirsten L. Rennie, L. Balian, Luke Howard, L Pippard, K. Rennie, T Pitt-Kerby, Luke Howard, L Pippard, S. Board, T Pitt-Kerby - European Journal of Internal Medicine 2022 被引用: 18

BACKGROUND: The prevalence of atrial fibrillation(AF) and diabetes mellitus is rising to epidemic proportions. We aimed to assess the impact of diabetes on the management and outcomes of patients with AF. METHODS: The EORP-AF General Long-Term Registry is a prospective, observational registry from 250 centres across 27 European countries. Outcomes of interest were as follows: i)rhythm control interventions; ii)quality of life; iii)healthcare resource utilisation; and iv)major adverse events. RESULTS: Of 11,028 patients with AF, the median age was 71 (63-77) years and 2537 (23.0%) had diabetes. Median follow-up was 24 months. Diabetes was related to increased use of anticoagulation but less rhythm control interventions. Using multivariable analysis, at 2-year follow-up, patients with diabetes were associated with greater levels of anxiety (p = 0.038) compared to those without diabetes. Overall, diabetes was associated with worse health during follow-up, as indicated by Health Utility Score and Visual Analogue Scale. Healthcare resource utilisation was greater with diabetes in terms of length of hospital stay (8.1 (±8.2) vs. 6.1 (±6.7) days); cardiology and internal medicine/general practitioner visits; and emergency room admissions. Diabetes was an independent risk factor of major adverse cardiovascular event (MACE; HR 1.26 [95% CI, 1.04-1.52]), all-cause mortality (HR 1.28 [95% CI, 1.08-1.52]), and cardiovascular mortality (HR 1.41 [95% CI, 1.09-1.83]). CONCLUSION: In this contemporary AF cohort, diabetes was present in 1 in 4 patients and it served as an independent risk factor for reduced quality of life, greater healthcare resource utilisation and excess MACE, all-cause mortality and cardiovascular mortality. There was increased use of anticoagulation therapy in diabetes but with less rhythm control interventions.