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Association of Diabetes Duration and Glycemic Control With Stroke Rate in Patients With Atrial Fibrillation and Diabetes: A Population‐Based Cohort Study
BACKGROUND: There are limited data on the association of diabetes duration and glycemic control with stroke risk in atrial fibrillation (AF). Our objective was to study the association of diabetes duration and glycated hemoglobin (HbA1c) with the rate of stroke in people with diabetes and newly diag...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245806/ https://www.ncbi.nlm.nih.gov/pubmed/35132863 http://dx.doi.org/10.1161/JAHA.121.023643 |
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author | Abdel‐Qadir, Husam Gunn, Madison Lega, Iliana C. Pang, Andrea Austin, Peter C. Singh, Sheldon M. Jackevicius, Cynthia A. Tu, Karen Dorian, Paul Lee, Douglas S. Ko, Dennis T. |
author_facet | Abdel‐Qadir, Husam Gunn, Madison Lega, Iliana C. Pang, Andrea Austin, Peter C. Singh, Sheldon M. Jackevicius, Cynthia A. Tu, Karen Dorian, Paul Lee, Douglas S. Ko, Dennis T. |
author_sort | Abdel‐Qadir, Husam |
collection | PubMed |
description | BACKGROUND: There are limited data on the association of diabetes duration and glycemic control with stroke risk in atrial fibrillation (AF). Our objective was to study the association of diabetes duration and glycated hemoglobin (HbA1c) with the rate of stroke in people with diabetes and newly diagnosed AF. METHODS AND RESULTS: This was a population‐based cohort study using linked administrative data sets. We studied 37 209 individuals aged ≥66 years diagnosed with AF in Ontario between April 2009 and March 2019, who had diabetes diagnosed 1 to 16 years beforehand. The primary outcome was hospitalization for stroke at 1 year. Cause‐specific hazard regression was used to model the association of diabetes duration and glycated hemoglobin (HbA1c) with the rate of stroke. Restricted cubic spline analyses showed increasing hazard ratios (HR) for stroke with longer diabetes duration that plateaued after 10 years and increasing HRs for stroke with HbA1c levels >7%. Relative to patients with <5 years diabetes duration, stroke rates were significantly higher for patients with ≥10 years duration (HR, 1.45; 95% CI, 1.16–1.82; P=0.001), while diabetes duration 5 to <10 years was not significantly different. Relative to glycated hemoglobin 6% to <7%, values ≥8% were associated with higher stroke rates (HR, 1.44; 95% CI, 1.12–1.84; P=0.004), while other HbA1c categories were not significantly different. CONCLUSIONS: Longer diabetes duration and higher glycated hemoglobin were associated with significantly higher stroke rates in patients with AF and diabetes. Models for stroke risk prediction and preventive care in AF may be improved by considering patients’ diabetes characteristics. |
format | Online Article Text |
id | pubmed-9245806 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92458062022-07-01 Association of Diabetes Duration and Glycemic Control With Stroke Rate in Patients With Atrial Fibrillation and Diabetes: A Population‐Based Cohort Study Abdel‐Qadir, Husam Gunn, Madison Lega, Iliana C. Pang, Andrea Austin, Peter C. Singh, Sheldon M. Jackevicius, Cynthia A. Tu, Karen Dorian, Paul Lee, Douglas S. Ko, Dennis T. J Am Heart Assoc Original Research BACKGROUND: There are limited data on the association of diabetes duration and glycemic control with stroke risk in atrial fibrillation (AF). Our objective was to study the association of diabetes duration and glycated hemoglobin (HbA1c) with the rate of stroke in people with diabetes and newly diagnosed AF. METHODS AND RESULTS: This was a population‐based cohort study using linked administrative data sets. We studied 37 209 individuals aged ≥66 years diagnosed with AF in Ontario between April 2009 and March 2019, who had diabetes diagnosed 1 to 16 years beforehand. The primary outcome was hospitalization for stroke at 1 year. Cause‐specific hazard regression was used to model the association of diabetes duration and glycated hemoglobin (HbA1c) with the rate of stroke. Restricted cubic spline analyses showed increasing hazard ratios (HR) for stroke with longer diabetes duration that plateaued after 10 years and increasing HRs for stroke with HbA1c levels >7%. Relative to patients with <5 years diabetes duration, stroke rates were significantly higher for patients with ≥10 years duration (HR, 1.45; 95% CI, 1.16–1.82; P=0.001), while diabetes duration 5 to <10 years was not significantly different. Relative to glycated hemoglobin 6% to <7%, values ≥8% were associated with higher stroke rates (HR, 1.44; 95% CI, 1.12–1.84; P=0.004), while other HbA1c categories were not significantly different. CONCLUSIONS: Longer diabetes duration and higher glycated hemoglobin were associated with significantly higher stroke rates in patients with AF and diabetes. Models for stroke risk prediction and preventive care in AF may be improved by considering patients’ diabetes characteristics. John Wiley and Sons Inc. 2022-02-08 /pmc/articles/PMC9245806/ /pubmed/35132863 http://dx.doi.org/10.1161/JAHA.121.023643 Text en © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Abdel‐Qadir, Husam Gunn, Madison Lega, Iliana C. Pang, Andrea Austin, Peter C. Singh, Sheldon M. Jackevicius, Cynthia A. Tu, Karen Dorian, Paul Lee, Douglas S. Ko, Dennis T. Association of Diabetes Duration and Glycemic Control With Stroke Rate in Patients With Atrial Fibrillation and Diabetes: A Population‐Based Cohort Study |
title | Association of Diabetes Duration and Glycemic Control With Stroke Rate in Patients With Atrial Fibrillation and Diabetes: A Population‐Based Cohort Study |
title_full | Association of Diabetes Duration and Glycemic Control With Stroke Rate in Patients With Atrial Fibrillation and Diabetes: A Population‐Based Cohort Study |
title_fullStr | Association of Diabetes Duration and Glycemic Control With Stroke Rate in Patients With Atrial Fibrillation and Diabetes: A Population‐Based Cohort Study |
title_full_unstemmed | Association of Diabetes Duration and Glycemic Control With Stroke Rate in Patients With Atrial Fibrillation and Diabetes: A Population‐Based Cohort Study |
title_short | Association of Diabetes Duration and Glycemic Control With Stroke Rate in Patients With Atrial Fibrillation and Diabetes: A Population‐Based Cohort Study |
title_sort | association of diabetes duration and glycemic control with stroke rate in patients with atrial fibrillation and diabetes: a population‐based cohort study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9245806/ https://www.ncbi.nlm.nih.gov/pubmed/35132863 http://dx.doi.org/10.1161/JAHA.121.023643 |
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