医学
心房颤动
内科学
糖尿病
危险系数
心脏病学
倾向得分匹配
视网膜病变
肾病
队列研究
糖尿病足
置信区间
内分泌学
作者
Eue‐Keun Choi,So‐Ryoung Lee,Eue Keun Choi,Hyo‐Jeong Ahn,Seung-Woo Lee,Jae-Hun Jung,Kyungdo Han,Seil Oh,Gregory Y.H. Lip
出处
期刊:Diabetes Care
[American Diabetes Association]
日期:2023-10-18
卷期号:46 (12): 2240-2248
被引量:3
摘要
OBJECTIVE This study aimed to investigate the associations between concurrent atrial fibrillation and diabetes-related complications among patients with diabetes. RESEARCH DESIGN AND METHODS This nationwide observational cohort study used the health checkup database from the Korean National Health Insurance Service. Patients diagnosed with diabetes who underwent health checkups between 2009 and 2012 were investigated. The patients with atrial fibrillation were matched in a 1:5 ratio with those without atrial fibrillation using propensity scores. Study outcomes included macrovascular, microvascular (diabetic retinopathy and diabetic nephropathy), and diabetic foot complications. The risks of clinical outcomes were measured using hazard ratios (HRs) with 95% CIs. RESULTS A total of 65,760 patients with diabetes were analyzed (54,800 without atrial fibrillation and 10,960 with atrial fibrillation). After well-balanced propensity score matching, atrial fibrillation was associated with significantly higher risks of macrovascular complications (HR 1.12, 95% CI 1.09–1.16), diabetic nephropathy (HR 1.23, 95% CI 1.16–1.30), and diabetic foot complications (HR 1.13, 95% CI 1.09–1.17) compared with no atrial fibrillation, while the risk of diabetic retinopathy was comparable (HR 0.99, 95% CI 0.96–1.03). Patients with atrial fibrillation had a significantly higher risk of diabetic foot amputation (HR 4.12, 95% CI 1.98–8.56). CONCLUSIONS Among patients with diabetes, concurrent atrial fibrillation was associated with increased risks for diabetes-related macrovascular complications, diabetic nephropathy, and diabetic foot. Such patients require holistic management to reduce the risk of adverse outcomes.
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