PMID- 31822042
OWN - NLM
STAT- MEDLINE
DCOM- 20210517
LR  - 20210517
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 22
IP  - 1
DP  - 2020 Jan
TI  - Type 2 diabetes increases the long-term risk of heart failure and mortality in 
      patients with atrial fibrillation.
PG  - 113-125
LID - 10.1002/ejhf.1666 [doi]
AB  - AIMS: Impact of type 2 diabetes mellitus (T2DM) on non-thromboembolic outcomes in 
      atrial fibrillation (AF) is insufficiently explored. This prospective cohort 
      study of AF patients aimed (i) to analyse the association between T2DM and heart 
      failure (HF) events (including new-onset HF), and all-cause and cardiovascular 
      mortality, (ii) to assess the impact of baseline T2DM treatment on outcomes, and 
      (iii) to explore characteristics of new-onset HF phenotypes in relation to T2DM 
      status. METHODS AND RESULTS: Of 1803 AF patients (515/1288, with/without prior 
      HF), 389 (22%) had T2DM at baseline. After 5 years of median follow-up, T2DM 
      patients had an 85% greater risk of HF events [adjusted hazard ratio (aHR) 1.85; 
      95% confidence interval (CI) 1.51-2.28; P < 0.001], including a 45% increased 
      risk for new-onset HF (1.45; 1.17-2.28; P = 0.015). T2DM conferred a 56% higher 
      all-cause (1.56, 1.22-2.01; P = 0.003) and a 48% higher cardiovascular mortality 
      (1.48; 1.34-1.93; P = 0.007). Fine-Gray analysis, with mortality as a competing 
      risk, confirmed greater HF risk among T2DM patients. All risks were highest among 
      insulin-treated patients. The prevalence of new-onset HF phenotypes was as 
      follows: 67% preserved ejection fraction (HFpEF), 20% mid-range ejection fraction 
      (HFmrEF) and 13% reduced ejection fraction (HFrEF). On time-dependent Cox 
      regression, adjusted for baseline characteristics and an interim acute coronary 
      event, T2DM increased aHRs for new-onset HFpEF (2.38; 1.30-4.58; P <0.001) and 
      the combined HFmrEF/HFrEF (1.77; 1.11-3.62; P = 0.017). CONCLUSIONS: Atrial 
      fibrillation patients with T2DM have independently increased risk of 
      new-onset/recurrent HF events, cardiovascular and all-cause mortality, 
      particularly when insulin-treated. The prevailing phenotype of new-onset HF was 
      HFpEF; T2DM conferred higher risk of both HFpEF and HFmrEF/HFrEF.
CI  - (c) 2019 The Authors. European Journal of Heart Failure (c) 2019 European Society of 
      Cardiology.
FAU - Polovina, Marija
AU  - Polovina M
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
AD  - Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
FAU - Lund, Lars H
AU  - Lund LH
AD  - Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, 
      Karolinska University Hospital, Stockholm, Sweden.
FAU - Dikic, Dijana
AU  - Dikic D
AD  - Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
FAU - Petrovic-Dordevic, Ivana
AU  - Petrovic-Dordevic I
AD  - Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
FAU - Krljanac, Gordana
AU  - Krljanac G
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
AD  - Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
FAU - Milinkovic, Ivan
AU  - Milinkovic I
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
AD  - Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
FAU - Veljic, Ivana
AU  - Veljic I
AD  - Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
FAU - Piepoli, Massimo F
AU  - Piepoli MF
AD  - Heart Failure Unit, Cardiology, G. da Saliceto Hospital, Piacenza, Italy.
FAU - Rosano, Giuseppe M C
AU  - Rosano GMC
AD  - Department of Medical Sciences, IRCCS San Raffaele, Rome, Italy.
AD  - Cardiology Clinical Academic Group, St George's Hospitals NHS Trust University of 
      London, London, UK.
FAU - Ristic, Arsen D
AU  - Ristic AD
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
AD  - Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
FAU - Asanin, Milika
AU  - Asanin M
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
AD  - Department of Cardiology, Clinical Centre of Serbia, Belgrade, Serbia.
FAU - Seferovic, Petar M
AU  - Seferovic PM
AD  - Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
AD  - Serbian Academy of Sciences and Arts, Belgrade, Serbia.
LA  - eng
PT  - Journal Article
DEP - 20191210
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
MH  - *Atrial Fibrillation/complications/epidemiology
MH  - *Diabetes Mellitus, Type 2/complications/epidemiology
MH  - *Heart Failure/epidemiology/etiology
MH  - Humans
MH  - Prognosis
MH  - Prospective Studies
MH  - Stroke Volume
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - Cardiovascular risk
OT  - Heart failure
OT  - Insulin
OT  - Mortality
OT  - Prognosis
OT  - Treatment
OT  - Type 2 diabetes mellitus
EDAT- 2019/12/11 06:00
MHDA- 2021/05/18 06:00
CRDT- 2019/12/11 06:00
PHST- 2019/06/30 00:00 [received]
PHST- 2019/06/30 00:00 [revised]
PHST- 2019/10/08 00:00 [accepted]
PHST- 2019/12/11 06:00 [pubmed]
PHST- 2021/05/18 06:00 [medline]
PHST- 2019/12/11 06:00 [entrez]
AID - 10.1002/ejhf.1666 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2020 Jan;22(1):113-125. doi: 10.1002/ejhf.1666. Epub 2019 Dec 
      10.