Aging, Diabetic Nephropathy and Multiple Macrovascular Involvement are Associated with Atrial Fibrillation in Type 2 Diabetes Mellitus
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2014, Vol 4, Issue 32
Abstract
Background: Atrial fibrillation (AF) is the most common arrhythmia in the world and a recognized risk factor for stroke and death. Aims: To establish the association between atrial fibrillation and markers of glucose homeostasis as well as anthropometric, laboratory and clinical variables in type 2 diabetes. Study Design: Cross-sectional retrospective study. Place and Duration of Study: Unit of Metabolic and Endocrine Diseases, “Centro Catanese di Medicina e Chirurgia” Clinic, Catania, Italy, between January 1, 2008, and January 1, 2014 Methods: We included 6,920 type 2 diabetic (T2D) patients (mean age 66.4±11.4 years, 50.4% men) treated in specialist diabetes center. Persistent AF was assessed by clinical history and confirmed (by a single cardiologist) by a resting 12-lead electrocardiogram. Demographic, clinical and laboratory parameters were included in the analyses, as well as vascular laboratory studies. Standardized procedures were used to assess microvascular complications and Metabolic Syndrome (MetS). Results: In total, 6,455 (93.3%) patients had no evidence of atrial arrhythmia and the remaining 465 (6.7%) had AF. The prevalence of AF increased with age (peak of prevalence after 75 years in both sexes) and it was significantly greater in men (p=0.02). AF was significantly associated with hypercreatininemia, eGFR (and more advanced stage of Chronic Kidney Disease, CKD) and albuminuria (p<0.0001) as well as the diagnosis of cardio-vascular disease (CVD, p<0.0001). In a multivariate logistic regression analysis, age (OR 1.08, 95% CI 1.05-1.11, p<0.0001), male sex (OR 2.46, 95% CI 1.5-3.9, p=0.0002), estimated Glomerular Filtration Rate (eGFR) (OR 0.99, 95% CI 0.98-0.99, p=0.02) and the presence of CVD (OR 1.65, 95% CI 1.01-2.75, p=0.04) were all independent factors related to AF. When we subgrouped patients according to cardiovascular patterns, an adjusted analysis revealed a significant difference only in the poly-vascular subgroup (OR 2.24, 95% CI 1.26-3.99, p=0.006). Conclusion: Aging, CKD and cardiovascular disease (particularly poly-vascular involvement) were the most significant AF-related factors. In T2D patients, the identification of factors predisposing individuals to AF may facilitate an early diagnosis and stroke prevention therapy.
Authors and Affiliations
G. Papa, M. P. Iurato, C. Licciardello, R. Maiorana, V. Pezzino
Keywords
Related Articles
- EP ID EP349079
- DOI 10.9734/BJMMR/2014/11918
- Views 43
- Downloads 0
Health Services' Profile Introduced to under Five Rural Egyptian Children: A Cross-Sectional Study
Background: Children under 5 years of age represent 11.1% of total Egyptians with a mortality rate of 22/1000 live births in 2013. Family health centers are the first gates that provide them with health services. This st...
Faculty Perception and Attitude on Problem Based Learning (PBL) in Medical College from Central India
Background: PBL is an innovative teaching learning method that enhances intrinsic motivation, promotes self learning, encourages clinical reasoning, and develops long-lasting memory. It is an established leading educati...
The Association between Cyclo-oxygenase Inhibitor Medications and Clinical Relapse in Inflammatory Bowel Disease: Review of Current Perspectives
Background: Patients with inflammatory bowel disease (IBD) often have associated conditions which may benefit from treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or selective cyclo-oxygenase-2 (COX-2) inhi...
Spirometric Values in Healthy Nigerian School Children Aged 6-11 Years
Background: Respiratory disorders are among the leading cause of morbidity and mortality in children and the use of spirometry in measuring lung function, diagnosing and monitoring of variety of paediatric respiratory di...
Self-perception of Venous Symptoms and Quality of Life Analysis in Wheelchair Athletes and Non-athletes: A Pilot Study
Aims: Evaluate the impact of the physical activity in individuals with muscular atrophy on the inferior members (wheelchair users) considering two main aspects: the quality of life and the self-perception of the venous r...