한빛사논문
- 조회529
Soonil Kwon 1, So-Ryoung Lee 1,2, Eue-Keun Choi 1,2, Hyo-Jeong Ahn 1, Seung-Woo Lee 3, Jin-Hyung Jung 3, Kyung-Do Han 4, Seil Oh 1,2, Gregory Y H Lip 1,2,5,6
1Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
3Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
4Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
5Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Chest and Heart Hospital, Liverpool, U.K.
6Danish Center for Clinical Health Services Research, Aalborg University, Aalborg, Denmark.
S.K. and S.-R.L. contributed equally to this work.
Corresponding author: Eue-Keun Choi
Abstract
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.
논문정보
- Research article
- 2023년 10월 (BRIC 등록일 2023-10-19)
- 국내(교신)+국외 연구진
- 의약학 > 응용의학
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