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        Clinical Characteristics and Impact of Diabetes Mellitus on Outcomes in Patients with Nonvalvular Atrial Fibrillation

        Bi Huang,양안민,Jun Zhu,Yan Liang,Han Zhang,Li Tian,Xinghui Shao,Juan Wang 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.1

        Purpose: Studies have shown that diabetes mellitus (DM) is a risk factor for cardiovasculardisease, including atrial fibrillation (AF); however, the clinical characteristicsand prognostic impact of DM in patients with nonvalvular AF have not been well understood in China. Materials and Methods: Included were 1644 consecutive patients with nonvalvular AF. Endpoints included all-cause mortality, cardiovascular mortality, stroke, major bleeding, and combined endpoint events (CEE) during a 1-year follow-up. Results: The prevalence of DM was 16.8% in nonvalvular AF patients. Compared with non-diabetic AF patients, diabetic AF patientswere older and tended to coexist with other cardiovascular diseases. Most patients with DM (93.5%) were eligible for anticoagulation, as determined by CHADS2 scores. However, only 11.2% of patients received anticoagulation. Duringa 1-year follow-up, the all-cause mortality and CEE rate in the DM group were significantly higher than those of the non-DM group, while the incidence of stroke was comparable. After multivariate adjustments, DM was still an independent risk factor for 1-year all-cause mortality [hazard ratio (HR)=1.558; 95% confidence interval(CI) 1.126‒2.156; p=0.007], cardiovascular mortality (HR=1.615; 95% CI 1.052‒2.479; p=0.028), and CEE (HR=1.523; 95% CI 1.098‒2.112; p=0.012), yet not for stroke (HR=1.119; 95% CI 0.724‒1.728; p=0.614). Conclusion: DM is a common morbidity coexisting with nonvalvular AF and is associated with an increasedrisk of 1-year all-cause mortality, cardiovascular mortality, and CEE. However, no increased risk of stroke was found during a 1-year follow-up in patientswith AF and DM.

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