Publication: Outcomes of patients with atrial fibrillation with and without diabetes: A propensity score matching of the COOL-AF registry
Issued Date
2021-11-01
Resource Type
ISSN
17421241
13685031
13685031
Other identifier(s)
2-s2.0-85112600246
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Clinical Practice. Vol.75, No.11 (2021)
Suggested Citation
Rungroj Krittayaphong, Suchart Aroonsiriwattana, Pornchai Ngamjanyaporn, Thanasak Patmuk, Pontawee Kaewkumdee Outcomes of patients with atrial fibrillation with and without diabetes: A propensity score matching of the COOL-AF registry. International Journal of Clinical Practice. Vol.75, No.11 (2021). doi:10.1111/ijcp.14671 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/77738
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Title
Outcomes of patients with atrial fibrillation with and without diabetes: A propensity score matching of the COOL-AF registry
Abstract
Background: To investigate the clinical outcomes of patients with non-valvular atrial fibrillation (NVAF) compared between those with and without diabetes mellitus (DM). Methods: We conducted a prospective multicenter nationwide registry for patients with NVAF from 27 hospitals in Thailand. Patients were followed-up every 6 months until 3 years. The outcome measurements were ischemic stroke (IS) or transient ischemic attack (TIA), major bleeding, and heart failure (HF). All reported events were confirmed by the adjudication committee. DM was diagnosed by history or laboratory data. Results: We studied 3402 patients. DM was diagnosed in 923 patients (27.1%). The average follow-up duration was 25.74 ± 10.57 months (7912 persons-year). The rate of IS/TIA, major bleeding, and HF was 1.42, 2.11, and 3.03 per 100 person-years. Patients with DM had a significantly increased risk of IS/TIA, major bleeding, and HF. After adjusting for age, gender, comorbid conditions, and the use of oral anticoagulant (OAC) using propensity score matching, DM remained a significant predictor of ischemic stroke/TIA, major bleeding and HF with Hazard ratio and 95% confidence interval of 1.67 (1.02, 2.73), 1.65 (1.13, 2.40), and 1.87 (1.34, 2.59), respectively. The net clinical benefit of OAC was more pronounced in DM patients (0.88 events per 100 person-years) than in those without DM (−0.73 events per 100 person-years). Conclusions: DM increases the risk of adverse clinical outcomes in NVAF patients. The benefit of OAC outweighs the risk in DM patients.