Incidence of atrial fibrillation, ischaemic heart disease and heart failure in patients with diabetes

Amy Groenewegen,Victor W Zwartkruis,Arno W Hoes,Betül Cekic,Monika Hollander,Michiel Rienstra,Rudolf A De Boer,Frans H Rutten

doi:10.1186/s12933-021-01313-7

Abstract

BackgroundDiabetes has strongly been linked to atrial fibrillation, ischaemic heart disease and heart failure. The epidemiology of these cardiovascular diseases is changing, however, due to changes in prevalence of obesity-related conditions and preventive measures. Recent population studies on incidence of atrial fibrillation, ischaemic heart disease and heart failure in patients with diabetes are needed.MethodsA dynamic longitudinal cohort study was performed using primary care databases of the Julius General Practitioners’ Network. Diabetes status was determined at baseline (1 January 2014 or upon entering the cohort) and participants were followed-up for atrial fibrillation, ischaemic heart disease and heart failure until 1 February 2019. Age and sex-specific incidence and incidence rate ratios were calculated.ResultsMean follow-up was 4.2 years, 12,168 patients were included in the diabetes group, and 130,143 individuals in the background group. Incidence rate ratios, adjusted for age and sex, were 1.17 (95% confidence interval 1.06–1.30) for atrial fibrillation, 1.66 (1.55–1.83) for ischaemic heart disease, and 2.36 (2.10–2.64) for heart failure. Overall, incidence rate ratios were highest in the younger age categories, converging thereafter.ConclusionThere is a clear association between diabetes and incidence of the major chronic progressive heart diseases, notably with heart failure with a more than twice increased risk.

Highlights

Diabetes has strongly been linked to atrial fibrillation, ischaemic heart disease and heart failure
The majority (~ 84%) of patients with diabetes is enrolled in primary care disease management programs (DMPs) and visits their general practitioner (GP) on a regular basis for monitoring of their diabetes and potential cardiovascular complications
Person-time and numbers of cases per sub-cohort are presented in Fig. 2

Summary

Introduction

Diabetes has strongly been linked to atrial fibrillation, ischaemic heart disease and heart failure. The epidemiology of these cardiovascular diseases is changing, due to changes in prevalence of obesity-related conditions and preventive measures. Recent population studies on incidence of atrial fibrillation, ischaemic heart disease and heart failure in patients with diabetes are needed. The incidence of atrial fibrillation and heart failure in younger people (< 55 years old) is on the rise [10, 11] This has, in part, been explained by the dramatic world-wide increase of obesity, [12, 13] improved awareness and better registration likely play a role [14, 15]

Methods

Results

Discussion

Conclusion