Relationship of adverse events to quality of anticoagulation control in atrial fibrillation patients with diabetes: real-world data from the FANTASIIA Registry

Background: Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events. Purpose To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status. Methods: AF patients from FANTASIIA registry were included. Basel...

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Authors: García-Fernández, Amaya, Esteve-Pastor, María Asunción, Roldán-Rabadán, Inmaculada, Muñiz, Javier, Ruiz Ortiz, Martín, Cequier Fillat, Àngel R., Bertomeu-Martínez, Vicente, Badimón, Lina, 1953-, Otero, Deborah, Anguita Sánchez, Manuel, Lip, Gregory Y.H., Marín, Francisco, FANTASIIA Study Investigators
Format: article
Status:Published version
Publication Date:2020
Country:España
Institution:Universidad de Barcelona
Repository:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/195535
Online Access:https://hdl.handle.net/2445/195535
Access Level:Open access
Keyword:Fibril·lació auricular
Diabetis
Comorbiditat
Atrial fibrillation
Diabetes
Comorbidity
Description
Summary:Background: Atrial fibrillation (AF) patients with diabetes (DM) have high risk of cardiovascular events. Purpose To compare clinical characteristics, adverse outcomes and quality of anticoagulation in AF patients regarding DM status. Methods: AF patients from FANTASIIA registry were included. Baseline characteristics and comorbidities were recorded. After 2-years follow-up, the association between adverse events and DM was evaluated. Results: 1956 patients (mean age 73.8 ± 9.5 years, 56% male) were analyzed; 574 (29.3%) had DM. Diabetic patients had also high prevalence of hypertension (90.6% vs 76.1%; p < .001) or renal disease (21.4% vs 15.9%; p < .001). After median follow-up of 1077 days (IQR 766-1113 days), diabetic patients had high total mortality (16.9%/year vs 11.4%/year; p < .001), cardiovascular mortality (9.1%/year vs 3.9%/year; p < .001) and MACE (12.9%/year vs 6.8%/year; p < .001). DM patients had poor anticoagulation control (time in therapeutic range: 58.52 ± 24.37% vs 62.68 ± 25.31%; p = .002). DM with lower TTR showed higher cardiovascular death and MACE. Multivariate analysis showed an independent association between DM and cardiovascular mortality [HR 1.73 (IC95% 1.07-2.80); p = .024]. Conclusion: AF Diabetic patients have higher comorbidities and poorer TTR than nondiabetic patients. Low TTR was associated with adverse events. The risk of cardiovascular outcomes was higher in DM patients, with independent association between DM and mortality risk.

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