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A Hammoudeh, W Alzyoud, D Ja"ara, M Bahour, R Nasereddin, E Al-Mousa, Y Badaineh, When type 2 diabetes coexists with atrial fibrillation in Middle Eastern patients: Clinical profiles and utilization of oral anticoagulant agents, European Heart Journal, Volume 43, Issue Supplement_1, February 2022, ehab849.020, https://doi.org/10.1093/eurheartj/ehab849.020
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Abstract
Type of funding sources: None.
The Jordan Atrial Fibrillation (JoFib) Study
Background. Studies from different regions in the world have shown that patients with atrial fibrillation (AF) who have type 2 diabetes mellitus (T2D) have unfavorable baseline clinical profile, higher prevalence of comorbidities and higher risk scores compared with those who do not have T2D. It is largely unknown if this applies to Middle Eastern (ME) patients.
Purpose. To evaluate baseline clinical features, prevalence of comorbid diseases, CHA2DS2-VASc scores in AF patients with T2D, and the utilization of oral anticoagulant agents (OACs) compared with those who do not have T2D in a large ME cohort.
Methods. Of 2163 AF patients enrolled in the Jordan AF study (May 2019 - January 2021), 953 (44.1%) had T2D and 1210 (55.9%) did not have T2D. Nonvalvular AF (NVAF) was diagnosed in 94% and 89% of both groups, respectively. Compared with AF patients who did not have T2D, those with T2D were older (mean age 70.3 ± 9.7 years vs. 65.9 ± 15.1 years, p < 0.001), more likely to be women (56.3% vs. 51.9%, p = 0.05), and had higher prevalence of hypertension (88.6% vs. 63.7%, p < 0.001) and obesity (71.9% vs. 43.6%, p < 0.001). More AF patients with T2D had high risk CHA2DS2-VASc score (>3 in women and >2 in men) than those with no T2D (96.9% vs. 72.3%, p < 0.001). Furthermore, they had higher prevalence of past stroke/systemic embolization (19.2% vs. 15.0%, p = 0.01), heart failure (29.3% vs. 19.7%, p < 0.001) and coronary artery disease (14.0% vs. 8.2%, p = 0.001). OACs utilization was not different in AF patients with or without T2D (83.4% vs. 85.9%, p = 0.19, respectively). Multivariate analysis showed that high CHA2DS2-Vasc and low HAS-BLED scores, age 50-75 years, history of stroke, and non-paroxysmal AF, but not T2D, were associated with higher rates of OACs utilization among patients with NVAF.
Conclusions. The coexistence of AF and T2D in a large Middle Eastern cohort was associated with unfavorable baseline clinical profile and risk scores. The great majority of AF patients were prescribed OACs, independent of the presence or absence of T2D.
