ISSN 2149-2263 | E-ISSN 2149-2271
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Impact of long-term glycemic variability on development of atrial fibrillation in type 2 diabetic patients [Anatol J Cardiol]
Anatol J Cardiol. 2017; 18(6): 410-416 | DOI: 10.14744/AnatolJCardiol.2017.7938

Impact of long-term glycemic variability on development of atrial fibrillation in type 2 diabetic patients

Jun Gu, Yu- Qi Fan, Jun- Feng Zhang, Chang- Qian Wang
Department of Cardiology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai-People's Republic of China

Objective: It is well known that patients with type 2 diabetes mellitus (T2DM) have a high risk of atrial fibrillation (AF). The current study was designed to determine the relationship between long-term glycemic variability and incidence of new-onset AF in T2DM patients.
Methods: Between January 2008 and December 2009, we conducted a retrospective cohort study in patients with T2DM referred to our hospital. In 505 consecutive patients without any medical history of AF at baseline, the relationship between hemoglobin A1c (HbA1c) variability and future AF incidence was evaluated, with adjustments for other possible confounding factors. HbA1c variability was determined by standard deviation (SD) and coefficient of variation (CV).
Results: Over a median of 6.9-year follow-up period, 48 patients (9.5%) developed incident AF. Multiple cox regression revealed that higher HbA1c-SD (HR: 1.726, 95% CI: 1.104–1.830, p=0.001) or HbA1c-CV (HR: 1.241, 95% CI: 1.029–1.497, p=0.024) remained the remarkable predictor of new-onset AF after adjusting for age, body mass index, left ventricular mass index, and left atrium diameter. Receiver operating curve analysis identified thresholds for HbA1c-SD (0.665%, sensitivity 71.4%, specificity 54.9%) and HbA1c-CV (8.970%, sensitivity 73.8%, specificity 47.1%) to detect new-onset AF development.
Conclusion: In patients with T2DM, higher HbA1c variability is significantly associated with future AF development.

Keywords: hemoglobin A1c variability, type 2 diabetes mellitus; atrial fibrillation

Jun Gu, Yu- Qi Fan, Jun- Feng Zhang, Chang- Qian Wang. Impact of long-term glycemic variability on development of atrial fibrillation in type 2 diabetic patients. Anatol J Cardiol. 2017; 18(6): 410-416

Corresponding Author: Jun Gu, China
Manuscript Language: English


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