Cardiometabolic risk factors and disease trends for atrial fibrillation in individuals with type 1 diabetes: a nationwide registry study
Abstract Objective To investigate standardized incidence of atrial fibrillation (AF) in individuals with type 1 diabetes (T1DMM) compared with matched controls from the general population. Additionally, to examine optimal levels- and relative importance of risk factors associated with AF and numbers...
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BMC
2025-03-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-024-02561-z |
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| author | Lara El Khalili Linn El Khalili Araz Rawshani Jan Borén Deepak L. Bhatt Hertzel C. Gerstein Darren K. McGuire Edvin Helleryd Elmir Omerovic Björn Eliasson Truuls Råmunddal Naveed Sattar Aidin Rawshani |
| author_facet | Lara El Khalili Linn El Khalili Araz Rawshani Jan Borén Deepak L. Bhatt Hertzel C. Gerstein Darren K. McGuire Edvin Helleryd Elmir Omerovic Björn Eliasson Truuls Råmunddal Naveed Sattar Aidin Rawshani |
| author_sort | Lara El Khalili |
| collection | DOAJ |
| description | Abstract Objective To investigate standardized incidence of atrial fibrillation (AF) in individuals with type 1 diabetes (T1DMM) compared with matched controls from the general population. Additionally, to examine optimal levels- and relative importance of risk factors associated with AF and numbers of risk factors necessary to reduce excess risk in individuals with T1DM. Research design and methods The study included individuals with T1DM between 2001 and 2019 and matched controls without T1DM. The outcome of interest was the first occurrence of AF. Standardized incidence rates and Cox regression were used for analyzing incidence and risk associations. Results The study comprises analyses of data from 36,069 persons with T1DM and 165,705 matched controls; average age 34.1; 43.2% women. Incidence rates per 100,000 person years for AF in persons with T1DM declined between 2001 and 2019 from 671 to 494; also in controls from 568 to 317. However, results shows that those without cardiovascular disease at baseline, did not display a similar rate reduction over time. During this period, people with T1DM had a 1.34-fold (95% CI 1.24–1.46) higher adjusted hazard for incident AF than controls when adjusting for sociodemographic factors. This hazard was attenuated to 0.95 (95% CI 0.87–1.03) after also accounting for coronary, cerebrovascular, kidney disease and heart failure; among those with T1DM. In those, with several risk factors at baseline, we observed a hazard ratio from 1.61 (95%, 1.07–2.43), and there was also an indication of clear risk reduction in those with zero risk factors, albeit non-significant (HR 0.60, 95% CI 0.35–1.04). In the T1DM cohort, the first available value of hemoglobin A1c, systolic blood pressure, body mass index and estimated glomerular filtration rate were each independently associated with incident AF and we noticed a clear linear risk increase for several cardiometabolic risk factors. Conclusions The crude incidence of AF was higher for persons with versus without T1DM, and declined significantly in both groups. Adjusting for data-derived predictors of AF attenuated higher risks, suggesting that the higher AF risk for persons with T1DM is driven by its common comorbidities. |
| format | Article |
| id | doaj-art-0d7be237206c40c1bc2b7be4d6e7e2df |
| institution | DOAJ |
| issn | 1475-2840 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj-art-0d7be237206c40c1bc2b7be4d6e7e2df2025-08-20T03:01:41ZengBMCCardiovascular Diabetology1475-28402025-03-0124111210.1186/s12933-024-02561-zCardiometabolic risk factors and disease trends for atrial fibrillation in individuals with type 1 diabetes: a nationwide registry studyLara El Khalili0Linn El Khalili1Araz Rawshani2Jan Borén3Deepak L. Bhatt4Hertzel C. Gerstein5Darren K. McGuire6Edvin Helleryd7Elmir Omerovic8Björn Eliasson9Truuls Råmunddal10Naveed Sattar11Aidin Rawshani12Department of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgIcahn School of Medicine at Mount Sinai Health SystemPopulation Health Research Institute, McMaster University and Hamilton Health SciencesDepartment of Internal Medicine, University of Texas Southwestern Medical CenterDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgInstitute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research CentreDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgAbstract Objective To investigate standardized incidence of atrial fibrillation (AF) in individuals with type 1 diabetes (T1DMM) compared with matched controls from the general population. Additionally, to examine optimal levels- and relative importance of risk factors associated with AF and numbers of risk factors necessary to reduce excess risk in individuals with T1DM. Research design and methods The study included individuals with T1DM between 2001 and 2019 and matched controls without T1DM. The outcome of interest was the first occurrence of AF. Standardized incidence rates and Cox regression were used for analyzing incidence and risk associations. Results The study comprises analyses of data from 36,069 persons with T1DM and 165,705 matched controls; average age 34.1; 43.2% women. Incidence rates per 100,000 person years for AF in persons with T1DM declined between 2001 and 2019 from 671 to 494; also in controls from 568 to 317. However, results shows that those without cardiovascular disease at baseline, did not display a similar rate reduction over time. During this period, people with T1DM had a 1.34-fold (95% CI 1.24–1.46) higher adjusted hazard for incident AF than controls when adjusting for sociodemographic factors. This hazard was attenuated to 0.95 (95% CI 0.87–1.03) after also accounting for coronary, cerebrovascular, kidney disease and heart failure; among those with T1DM. In those, with several risk factors at baseline, we observed a hazard ratio from 1.61 (95%, 1.07–2.43), and there was also an indication of clear risk reduction in those with zero risk factors, albeit non-significant (HR 0.60, 95% CI 0.35–1.04). In the T1DM cohort, the first available value of hemoglobin A1c, systolic blood pressure, body mass index and estimated glomerular filtration rate were each independently associated with incident AF and we noticed a clear linear risk increase for several cardiometabolic risk factors. Conclusions The crude incidence of AF was higher for persons with versus without T1DM, and declined significantly in both groups. Adjusting for data-derived predictors of AF attenuated higher risks, suggesting that the higher AF risk for persons with T1DM is driven by its common comorbidities.https://doi.org/10.1186/s12933-024-02561-zAtrial fibrillationCardiometabolic diseaseType 1 diabetes mellitusCardiometabolic risk factorsCardiovascular medicinePopulation health |
| spellingShingle | Lara El Khalili Linn El Khalili Araz Rawshani Jan Borén Deepak L. Bhatt Hertzel C. Gerstein Darren K. McGuire Edvin Helleryd Elmir Omerovic Björn Eliasson Truuls Råmunddal Naveed Sattar Aidin Rawshani Cardiometabolic risk factors and disease trends for atrial fibrillation in individuals with type 1 diabetes: a nationwide registry study Cardiovascular Diabetology Atrial fibrillation Cardiometabolic disease Type 1 diabetes mellitus Cardiometabolic risk factors Cardiovascular medicine Population health |
| title | Cardiometabolic risk factors and disease trends for atrial fibrillation in individuals with type 1 diabetes: a nationwide registry study |
| title_full | Cardiometabolic risk factors and disease trends for atrial fibrillation in individuals with type 1 diabetes: a nationwide registry study |
| title_fullStr | Cardiometabolic risk factors and disease trends for atrial fibrillation in individuals with type 1 diabetes: a nationwide registry study |
| title_full_unstemmed | Cardiometabolic risk factors and disease trends for atrial fibrillation in individuals with type 1 diabetes: a nationwide registry study |
| title_short | Cardiometabolic risk factors and disease trends for atrial fibrillation in individuals with type 1 diabetes: a nationwide registry study |
| title_sort | cardiometabolic risk factors and disease trends for atrial fibrillation in individuals with type 1 diabetes a nationwide registry study |
| topic | Atrial fibrillation Cardiometabolic disease Type 1 diabetes mellitus Cardiometabolic risk factors Cardiovascular medicine Population health |
| url | https://doi.org/10.1186/s12933-024-02561-z |
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