Gender difference in association between diabetes mellitus and all-cause mortality in atrial fibrillation patients

Li Tian; Yan-Min Yang; Jun Zhu; Han Zhang; Xing-Hui Shao

doi:10.1016/j.jdiacomp.2022.108265

Gender difference in association between diabetes mellitus and all-cause mortality in atrial fibrillation patients

J Diabetes Complications. 2022 Sep;36(9):108265. doi: 10.1016/j.jdiacomp.2022.108265. Epub 2022 Jul 16.

Authors

Li Tian¹, Yan-Min Yang², Jun Zhu³, Han Zhang³, Xing-Hui Shao³

Affiliations

¹ Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, People's Republic of China; State Key Laboratory of Cardiovascular Disease, Emergency and Critical Care Centre of Cardiovascular Department, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China.
² State Key Laboratory of Cardiovascular Disease, Emergency and Critical Care Centre of Cardiovascular Department, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China. Electronic address: yymwin@gmail.com.
³ State Key Laboratory of Cardiovascular Disease, Emergency and Critical Care Centre of Cardiovascular Department, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China.

PMID: 35914400
DOI: 10.1016/j.jdiacomp.2022.108265

Abstract

Objective: There may be gender difference in correlation of diabetes mellitus (DM) and cardiovascular events. We attempt to investigate whether there is gender-heterogeneity in one-year outcomes of atrial fibrillation (AF) patients with DM or not.

Methods: Patients who were diagnosed with AF admitted to the emergency departments in the Chinese AF Multicenter Registry study were enrolled. Basic demographics information, initial Blood Pressure and heart rate, medical histories, and treatments of each patient were collected. Follow-up was carried out with a mean duration of one year. The primary endpoint was all-cause mortality and systemic embolism.

Results: A total of 2016 patients were selected from September 2008 and April 2011. All-cause mortality was significantly higher in male AF patients with DM than those without (21.8 % & 13.6 %, P = 0.014). Cox regression analysis showed that there was an interaction between gender and DM for one-year all-cause mortality (P = 0.049). DM was significantly associated with one-year all-cause mortality regardless of univariate analysis (HR = 1.436, 95%CI:1.079-1.911, P = 0.013) or multivariate analysis (HR = 1.418, 95%CI: 1.059-1.899, P = 0.019). For male patients with AF, DM was significantly associated with one-year all-cause mortality (P = 0.048), but not for female patients with AF (P = 0.362).

Conclusion: DM was independently associated with one-year all-cause mortality in the entire cohort of AF patients. This association was found mainly in male patients with AF, but not in female patients. DM management programs may need to reflect gender difference.

Keywords: Atrial fibrillation; Diabetes mellitus; Gender; Mortality; Systemic embolism.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Atrial Fibrillation* / complications
Atrial Fibrillation* / diagnosis
Atrial Fibrillation* / epidemiology
Diabetes Mellitus* / diagnosis
Diabetes Mellitus* / epidemiology
Female
Humans
Male
Registries
Risk Factors
Sex Factors