Role of CHA(2)DS(2)-VASc score in predicting new-onset atrial fibrillation in patients with type 2 diabetes mellitus with and without hyperosmolar hyperglycaemic state: real-world data from a nationwide cohort

PURPOSE: The objective of the current study was to explore the role of CHA(2)DS(2)-VASc score in predicting incidence of atrial fibrillation (AF) in patients with type 2 diabetes mellitus (DM). Furthermore, the use of the CHA(2)DS(2)-VASc score for stratifying new-onset AF risk in patients with DM and with/without hyperosmolar hyperglycaemic state (HHS) was also compared. METHODS: The study subjects were identified from Longitudinal Health Insurance Database provided by the National Health Research Institutes. The patients with DM were divided into two groups based on a history of HHS or not. The predictive ability of CHA(2)DS(2)-VASc score for stratifying new-onset AF risk in the two groups was calculated using the area under the curve of receiver-operating characteristic (AUROC). RESULTS: The present study involved a total of 69 530 patients with type 2 DM. Among them, 1558 patients had a history of HHS, whereas 67 972 patients did not. The AUROC of the CHA(2)DS(2)-VASc score as a predictor of incident AF in patients with DM and with/without HHS was 0.67 (95% CI 0.59 to 0.75) and 0.71 (95% CI 0.70 to 0.72), respectively. CONCLUSIONS: To conclude, we reported for the first time on the assessment of CHA(2)DS(2)-VASc score for incident AF risk discrimination in patients with type 2 DM. We further found that the predictive ability of the CHA(2)DS(2)-VASc score was attenuated in patients with type 2 DM and with HHS in comparison with those without HHS.