scholarly journals Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study

Author(s):  
Arjola Bano ◽  
Nicolas Rodondi ◽  
Jürg H. Beer ◽  
Giorgio Moschovitis ◽  
Richard Kobza ◽  
...  

Background Diabetes is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between patients who have AF with and without diabetes. This study investigated the association of diabetes with AF phenotype and cardiac and neurological comorbidities in patients with documented AF. Methods and Results Participants in the multicenter Swiss‐AF (Swiss Atrial Fibrillation) study with data on diabetes and AF phenotype were eligible. Primary outcomes were parameters of AF phenotype, including AF type, AF symptoms, and quality of life (assessed by the European Quality of Life‐5 Dimensions Questionnaire [EQ‐5D]). Secondary outcomes were cardiac (ie, history of hypertension, myocardial infarction, and heart failure) and neurological (ie, history of stroke and cognitive impairment) comorbidities. The cross‐sectional association of diabetes with these outcomes was assessed using logistic and linear regression, adjusted for age, sex, and cardiovascular risk factors. We included 2411 patients with AF (27.4% women; median age, 73.6 years). Diabetes was not associated with nonparoxysmal AF (odds ratio [OR], 1.01; 95% CI, 0.81–1.27). Patients with diabetes less often perceived AF symptoms (OR, 0.74; 95% CI, 0.59–0.92) but had worse quality of life (β=−4.54; 95% CI, −6.40 to −2.68) than those without diabetes. Patients with diabetes were more likely to have cardiac (hypertension [OR, 3.04; 95% CI, 2.19–4.22], myocardial infarction [OR, 1.55; 95% CI, 1.18–2.03], heart failure [OR, 1.99; 95% CI, 1.57–2.51]) and neurological (stroke [OR, 1.39, 95% CI, 1.03–1.87], cognitive impairment [OR, 1.75, 95% CI, 1.39–2.21]) comorbidities. Conclusions Patients who have AF with diabetes less often perceive AF symptoms but have worse quality of life and more cardiac and neurological comorbidities than those without diabetes. This raises the question of whether patients with diabetes should be systematically screened for silent AF. Registration URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT02105844.

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Bano ◽  
N Rodondi ◽  
J Beer ◽  
G Moschovitis ◽  
R Kobza ◽  
...  

Abstract Background Diabetes mellitus is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between AF patients with and without diabetes. Purpose To investigate the association of diabetes with AF phenotype, cardiac and neurological comorbidities in patients with documented AF. Methods Participants of the multicenter Swiss-AF study with available data on diabetes and AF phenotype were eligible. The primary outcomes were parameters of AF phenotype, including AF type (paroxysmal vs non-paroxysmal), AF symptoms (yes vs no), and quality of life (assessed by EQ-5D score). The secondary outcomes were cardiac (ie, history of hypertension, myocardial infarction, heart failure) and neurological comorbidities (ie, history of stroke, cognitive impairment). The cross-sectional association of diabetes with these outcomes was assessed using logistic and linear regression. Results were adjusted for age, sex, and cardiovascular risk factors. Results We included 2411 AF patients (27.4% women; median age, 73.6 years). Diabetes was not associated with non-paroxysmal AF (odds ratio [OR]=1.01; 95% confidence interval [CI]=0.81 to 1.27). Patients with diabetes less often perceived AF symptoms (OR=0.73; CI=0.59 to 0.91), but had worse quality of life (predicted mean difference in EQ-5D score: β=−4.54; CI=−6.40 to −2.68) than those without diabetes. Patients with diabetes were more likely to have cardiac comorbidities [history of hypertension (OR=3.04; CI=2.19 to 4.22), myocardial infarction (OR=1.55; CI=1.18 to 2.03), heart failure (OR=1.99; CI=1.57 to 2.51)] and neurological comorbidities [history of stroke (OR=1.39; CI=1.03 to 1.87), cognitive impairment (OR=1.75; CI=1.39 to 2.21)]. Conclusions In the Swiss-AF cohort population, patients with diabetes less often perceived AF symptoms, but had worse quality of life, more cardiac and neurological comorbidities than those without diabetes. These findings have significant clinical implications. The reduced perception of AF symptoms in patients with diabetes might result in a delayed AF diagnosis and consequently more adverse events, especially cardioembolic stroke. This raises the question whether patients with diabetes should be systematically screened for silent AF. Moreover, patients with concomitant AF and diabetes have increased likelihood of comorbidities and therefore deserve more attentive care. FUNDunding Acknowledgement Type of funding sources: None.


Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001726
Author(s):  
Anthony P Carnicelli ◽  
Ruth Owen ◽  
Stuart J Pocock ◽  
David B Brieger ◽  
Satoshi Yasuda ◽  
...  

ObjectiveAtrial fibrillation (AF) and myocardial infarction (MI) are commonly comorbid and associated with adverse outcomes. Little is known about the impact of AF on quality of life and outcomes post-MI. We compared characteristics, quality of life and clinical outcomes in stable patients post-MI with/without AF.Methods/resultsThe prospective, international, observational TIGRIS (long Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease) registry included 8406 patients aged ≥50 years with ≥1 atherothrombotic risk factor who were 1–3 years post-MI. Patient characteristics were summarised by history of AF. Quality of life was assessed at baseline using EQ-5D. Clinical outcomes over 2 years of follow-up were compared. History of AF was present in 702/8277 (8.5%) registry patients and incident AF was diagnosed in 244/7575 (3.2%) over 2 years. Those with AF were older and had more comorbidities than those without AF. After multivariable adjustment, patients with AF had lower self-reported quality-of-life scores (EQ-5D UK-weighted index, visual analogue scale, usual activities and pain/discomfort) than those without AF. CHA2DS2-VASc score ≥2 was present in 686/702 (97.7%) patients with AF, although only 348/702 (49.6%) were on oral anticoagulants at enrolment. Patients with AF had higher rates of all-cause hospitalisation (adjusted rate ratio 1.25 [1.06–1.46], p=0.008) over 2 years than those without AF, but similar rates of mortality.ConclusionsIn stable patients post-MI, those with AF were commonly undertreated with oral anticoagulants, had poorer quality of life and had increased risk of clinical outcomes than those without AF.Trial registration numberClinicalTrials: NCT01866904.


2020 ◽  
Vol 8 (E) ◽  
pp. 325-330
Author(s):  
Sultan M. Alshahrani ◽  
Moferrah Alzahran ◽  
Khaled Alakhali ◽  
Easwaran Vigneshwaran ◽  
Mir Javid Iqbal ◽  
...  

BACKGROUND: Diabetes mellitus (DM) is a major health-care burden worldwide. AIM: The aim of the study was to explore how the quality of life (QoL) of DM patients could be affected in the Aseer Province of the Kingdom of Saudi Arabia (KSA). METHODS: A cross-sectional, multicenter study in DM patients of both sexes and all age groups in Aseer Province were done using a validated self-administered questionnaire. The study was conducted between April 1, 2018 and November 25, 2018. RESULTS: A total of 418 patients completed our questionnaire, of which 240 (58%) were male and 178 (42%) were female. Furthermore, 50.23% were married and 104 (24.16%) were illiterate. We found that 403 (96.42%) respondents had type-2 DM and 315 (75.35%) had a family history of DM. In addition, 132 (31.57%) respondents were on monotherapy whereas only 61 (14.59%) were using combination therapy. Hypertension was the most prevalent comorbidity (166, 39.71%) and peripheral neuropathy the most prevalent complication of DM (157, 37.56%). CONCLUSION: DM had a significant impact on QoL among patients from Aseer Province in KSA. Our study underscores the importance of generating data on QoL among DM patients.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Isaac R Whitman ◽  
Mark J Pletcher ◽  
Eric Vittinghoff ◽  
Kourtney E Imburgia ◽  
Carol Maguire ◽  
...  

Background: Moderate consumption of alcohol may provide protection against myocardial infarction and mortality, but also likely increases blood pressure and incidence of atrial fibrillation. Despite the absence of rigorous controlled trials on the actual cardiovascular benefits of alcohol, the lay press frequently portrays alcohol as “heart healthy” (HH). No study to date has described individuals’ perceptions regarding the health effects of alcohol, how they gained this perception, nor how that perception may influence behavior. Methods: We performed a cross-sectional analysis of data obtained between March 8, 2013 to September 29, 2014 from consecutive participants enrolled in the Health eHeart Study, a prospective, internet-based cohort study. The characteristics of participants that reported alcohol as HH were determined. Results: A total of 5,417 participants answered questions regarding their perception of alcohol. Thirty percent (n=1,707) viewed alcohol as HH, 39% (n=2,157) viewed it as bad for the heart, and 31% (n=1,718) were unsure. Of those reporting alcohol as HH, 78% cited lay press as a source of their knowledge, 14% cited their doctor, and 92% reported that red wine exclusively was HH. In adjusted analyses, older age, higher education, higher income, and United States residence were associated with a perception of alcohol as HH (Figure). Those with a history of heart failure (HF) were significantly less likely to cite alcohol as HH. Compared to those who did not report alcohol as HH, those who perceived alcohol as HH consumed more alcohol (median 5 drinks per week, IQR 2-8 vs. median 3 drinks, IQR 1-7, p=0.001; adjusted: 10% more alcohol per week, 95% CI 1-20% more, p=0.02). Conclusions: Among more than 5,000 consecutive Health eHeart participants, approximately one third believe alcohol is HH and one third believes it is not. Those who believe alcohol is HH were of higher socioeconomic status, more likely to be American, less likely to have HF, and reported drinking more alcohol.


2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Vanessa Silveira Faria ◽  
Ligia Neres Matos ◽  
Liana Amorim Correa Trotte ◽  
Helena Cramer Veiga Rey ◽  
Tereza Cristina Felippe Guimarães

ABSTRACT Objective: to verify the association between the prognostic scores and the quality of life of candidates for heart transplantation. Method: a descriptive cross-sectional study with a convenience sample of 32 outpatients applying to heart transplantation. The prognosis was rated by the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM); and the quality of life by the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The Pearson correlation test was applied. Results: the correlations found between general quality of life scores and prognostic scores were (HFSS/MLHFQ r = 0.21), (SHFM/MLHFQ r = 0.09), (HFSS/KCCQ r = -0.02), (SHFM/KCCQ r = -0.20). Conclusion: the weak correlation between the prognostic and quality of life scores suggests a lack of association between the measures, i.e., worse prognosis does not mean worse quality of life and the same statement is true in the opposite direction.


Author(s):  
Juliana de Melo Vellozo Pereira Tinoco ◽  
Beatriz Paiva e Silva de Souza ◽  
Samara Xavier de Oliveira ◽  
Josiana Araujo de Oliveira ◽  
Evandro Tinoco Mesquita ◽  
...  

ABSTRACT Objective: To analyze sociodemographic and clinical characteristics, depressive symptoms and quality of life of patients with heart failure and associate quality of life with depressive symptoms. Method: A cross-sectional study conducted with outpatients and inpatients. Sociodemographic data were collected and questionnaires were applied to assess quality of life (Minnesota Living with Heart Failure Questionnaire) and depressive symptoms (Beck Depression Inventory). Results: The sample consisted of 113 patients. Outpatients were retired (p=0.004), with better education (p=0.034) and higher ventricular ejection fraction (p=0.001). The inpatient group had greater depressive symptoms (18.1±10 vs 14.6±1.3; p=0.036) and lower quality of life (74.1±18.7 vs 40.5±3.4; p<0.001) than the outpatient group. Outpatients with depressive symptom scores from 18 points had worse quality of life scores in 17 of the 21 questions. Conclusion: Inpatients had worse depressive symptoms and quality of life, which was more affected in the physical dimension in those with moderate/severe depressive symptoms. Outpatients with more severe depressive symptoms had worse quality of life in all dimensions.


Sign in / Sign up

Export Citation Format

Share Document