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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제56권 제1호
발행연도
2015.1
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62 - 71 (10page)

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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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