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Improved prognosis with integrated care management including early rhythm control and healthy lifestyle modification in patients with concurrent atrial fibrillation and diabetes mellitus: a nationwide cohort study
DC Field | Value | Language |
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dc.contributor.author | So‑Ryoung Lee | - |
dc.contributor.author | Hyo‑Jeong Ahn | - |
dc.contributor.author | Eue‑Keun Choi | - |
dc.contributor.author | Seung‑Woo Lee | - |
dc.contributor.author | Kyung‑Do Han | - |
dc.contributor.author | Seil Oh | - |
dc.contributor.author | Gregory Y. H. Lip | - |
dc.date.accessioned | 2023-02-27T01:22:16Z | - |
dc.date.available | 2023-02-27T01:22:16Z | - |
dc.date.issued | 2023-01-30 | - |
dc.identifier.citation | Cardiovascular Diabetology, 22(1):18 | ko_KR |
dc.identifier.uri | https://hdl.handle.net/10371/189112 | - |
dc.description.abstract | Background
Patients with concurrent atrial fibrillation (AF) and diabetes mellitus (DM) [AF-DM] have a high risk of cardiovascular and diabetes-related complications, but are less engaged in a comprehensive treatment approach. We evaluated the association of early rhythm control (ERC), lifestyle modification (LSM), and a combination of ERC and LSM with cardiovascular or diabetes-related complication risk in patients with AF-DM (type 2). Methods From the National Health Information Database, 47,940 patients diagnosed with AF-DM in 2009–2016 were included. We defined ERC as rhythm control therapy within two years of AF diagnosis and LSM as adherence to ≥ 2 of the healthy behaviors among non-current smoking, non-drinking, and regular exercise. We compared the primary (ischemic stroke) and secondary (macro- and microvascular complications, glycemic emergency, and all-cause death) outcomes in four groups: non-ERC and non-LSM (group 1), LSM only (group 2), ERC only (group 3), and both ERC and LSM (group 4). Results Of total, 10,617 (22%), 26,730 (55.8%), 2,903 (6.1%), and 7,690 (16.0%) were classified into groups 1 to 4, in sequence. The mean duration from AF diagnosis to ERC was 25.6 ± 75.5days. During 4.0 (interquartile range: 2.5–6.2) years follow-up, groups 2 and 3 were associated with 23% and 33% lower risks of stroke than group 1, respectively. Group 4 was associated with the lowest risk of stroke: hazard ratio (HR) 0.58, 95% confidence interval (CI) 0.51–0.67, p < 0.001. Regarding secondary outcomes, the lowest risks were also observed in group 4; macro- and microvascular complications, glycemic emergency, and all-cause death had HRs (95% CIs) of 0.63 (0.56–0.70), 0.88 (0.82–0.94), 0.72 (0.62–0.84), and 0.80 (0.73–0.87), respectively, all p < 0.001. Conclusions For AF-DM patients, ERC and LSM exert a synergistic effect in preventing cardiovascular and diabetes-related complications with the greatest lowered risk of stroke. A comprehensive treatment approach should be pursued in AF-DM patients. | ko_KR |
dc.description.sponsorship | This work was supported in part by a Korea Medical Device Development
Fund grant funded by the Korean government (the Ministry of Science and ICT; Ministry of Trade, Industry and Energy; Ministry of Health & Welfare; and Ministry of Food and Drug Safety) (project numbers: HI20C1662, 1711138358, and KMDF_PR_20200901_0173) and a grant from the Patient-Centered Clini‑ cal Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC21C0028). | ko_KR |
dc.language.iso | en | ko_KR |
dc.publisher | BMC | ko_KR |
dc.subject | Early rhythm control | - |
dc.subject | Lifestyle modification | - |
dc.subject | Atrial fibrillation | - |
dc.subject | Diabetes mellitus | - |
dc.title | Improved prognosis with integrated care management including early rhythm control and healthy lifestyle modification in patients with concurrent atrial fibrillation and diabetes mellitus: a nationwide cohort study | ko_KR |
dc.type | Article | ko_KR |
dc.identifier.doi | 10.1186/s12933-023-01749-z | ko_KR |
dc.citation.journaltitle | Cardiovascular Diabetology | ko_KR |
dc.language.rfc3066 | en | - |
dc.rights.holder | The Author(s) | - |
dc.date.updated | 2023-02-05T04:22:19Z | - |
dc.citation.endpage | 13 | ko_KR |
dc.citation.number | 18 | ko_KR |
dc.citation.startpage | 1 | ko_KR |
dc.citation.volume | 22 | ko_KR |
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