Table 2 Description of studies investigating the longitudinal association of DM with AF types
From: Association of diabetes with atrial fibrillation types: a systematic review and meta-analysis
First author, year (Reference) | Country | N | Population | Mean age (years) | Females (%) | DM assessment | Adjustment for potential confounders | Outcome (Ref) | Follow-up time | Result | |
|---|---|---|---|---|---|---|---|---|---|---|---|
A. Studies providing hazard ratios (Method: Cox regression) | |||||||||||
1 | Tsang, 2007 | United States | 3248 | Patients with first episode of paroxysmal AF | 71 ± 15 | 46 | DM medical diagnosis or treatment with antidiabetic medications | Age, sex | Permanent AF (Ref: no AF recurrence, recurrent paroxysmal AF, recurrent persistent AF) | Median (IQR), 5.1 (1.2–9.4) y | aHR (CI), 1.17 (0.94–1.47) |
2 | Pappone, 2008 | Italy | 106 | Patients with first episode of paroxysmal AF | 57.5 | 35.8 | NR | Age, HF | Permanent AF (Ref: no AF recurrence, recurrent paroxysmal AF, recurrent persistent AF) | Maximum, 5 y | aHR (CI), 17.37 (3.75–80.43) |
3 | Kawara, 2010 | Japan | 64 | Paroxysmal or persistent AF | 61 ± 10 | 29.6 | NR | Age, sex, HTN, organic heart disease, HF, severity of symptoms | Permanent AF (Ref: non-permanent AF) | Median (IQR), 4.9 (2.4–8.9) y | aHR (CI), 3.13 (0.46–21.2) |
4 | Thacker, 2013 | United States | 1385 | Patients whose initial AF episode terminated within 6 months | 69.2 | 48.7 | DM medical diagnosis, and current use of insulin or oral hypoglycemic medication | Age, sex | Permanent AF (Ref: non-permanent AF) | Mean (range), 7 (5–8) y | Model 1 aHR (CI), 0.99 (0.72–1.36) |
Age, sex, BMI, HTN, SBP, DBP | Model 2 aHR (CI), 0.93 (0.67–1.29) | ||||||||||
Age, sex, BMI, HTN, SBP, DBP, CHD, valvular heart disease, HF, stroke | Model 3 aHR (CI), 0.94 (0.67–1.32) | ||||||||||
5 | Senoo, 2014 | Japan | 1176 | Paroxysmal AF | 61.4 ± 13.1 | 25.6 | NR | - | Recurrent AF (Ref: non-recurrent AF) | Mean (sd), 3.3 ± 2.5 y | uHR (CI), 1.47 (0.89–2.44) |
6* | Sandhu, 2014 | United States | 1039 | Patients who developed AF in a cohort free of AF | 58.9 | 100 | NR | Age, aspirin, vitamin E, beta‐carotene, BMI, HTN, cholesterol, alcohol, smoking, exercise | Non-paroxysmal AF [i.e., persistent or permanent] (Ref: paroxysmal AF) | Median (IQR), 16.4 (15.6–16.8) y** | Model 1 aHR (CI), 1.04 (0.72 to 1.41)*** |
Age, MI, stroke, revascularization, HF | Model 2 aHR (CI), 1.06 (0.69–1.5)*** | ||||||||||
7 | Blum, 2019 | Switzerland | 2869 | Paroxysmal or persistent AF | 70 ± 9 | 32.3 | NR | Age, sex | AF Progression [i.e., paroxysmal to persistent or permanent, persistent to permanent] (Ref: paroxysmal or persistent AF) | Median (IQR), 3 (2–5) y | Model 1 aHR (CI), 1.14 (0.88–1.48) |
Age, sex, BMI, heart rate, SBP, coronary artery disease, HTN, stroke/TIA, HF, hyperthyroidism, history of renal failure, physical activity, smoking, history of pulmonary vein isolation, AF‐related symptoms, amiodarone | Model 2 aHR (CI), 0.92 (0.69–1.21) | ||||||||||
B. Studies providing odds ratios (Method: Logistic regression) | |||||||||||
8*† | Sakamoto, 1995 | Japan | 137 | Paroxysmal AF | 64 | 24.8 | Use of antidiabetic therapy | – | Chronic AF (Ref: paroxysmal AF) | Mean, 1 y | uOR (CI), 2.52 (1.05–6.05) |
9*† | Kerr, 2005 | Canada | 757 | Paroxysmal AF | 64 | 38.3 | NR | – | Chronic AF (Ref: paroxysmal AF) | 8 (0–11) y | uOR (CI), 1.07 (0.60–1.92) |
10* | Pillarisetti, 2009 | United States | 437 | Paroxysmal AF | 67.9 ± 13.4 | 43 | NR | – | Non-paroxysmal AF [i.e., persistant or permanent] (Ref: paroxysmal AF) | Mean (sd), 4.7 ± 4.6 y | uOR (CI), 1.50 (0.90–2.60) |
11*† | de Vos, 2010 | 35 European countries | 1219 | Paroxysmal AF and first detected AF in whom sinus rhythm restored spontaneously or after treatment during admission | 64 | 43 | NR | – | Non-paroxysmal AF [i.e., persistent or permanent] (Ref: paroxysmal AF) | Mean, 1 y | uOR (CI), 1.42 (0.94–2.14) |
12*† | de Vos, 2012 | 21 countries in Europe, North and South America, Asia | 2137 | Paroxysmal and first-detected AF | 65 ± 12 | NR | NR | – | Non-paroxysmal AF [i.e., persistent or permanent] (Ref: paroxysmal AF) | Mean, 1 y | uOR (CI), 1.18 (0.86–1.63) |
13 | Echouffo-Tcheugui, 2017 | United States | 6575 | Paroxysmal or persistent AF | 75 | 42.6 | Previous medical history or new DM diagnosis during enrollment visit | – | AF progression [i.e., paroxysmal to persistent or permanent, persistent to permanent] (Ref: paroxysmal or persistent AF) | Median (IQR), 2.78 (1.95–3) y | Model 1 uOR (CI), 1.05 (0.93–1.17) |
Age, sex, race, medical history, cardiovascular history | Model 2 aOR (CI), 0.96 (0.85, 1.08) | ||||||||||
14 | Schnabel, 2018 | 7 European countries | 2151 | Paroxysmal or persistent AF | 72 | 39.9 | NR | – | AF progression [i.e., paroxysmal to persistent or permanent, persistent to permanent] (Ref: paroxysmal or persistent AF) | Mean, 1 y | uOR (CI), 1.22 (0.98–1.52) |
Age, sex, country | aOR (CI), 1.23 (0.98–1.53) | ||||||||||
AF duration, HF, hyperthyroidism, no sinus rhythm, cardioversion, valvular heart disease | aOR (CI), 1.29 (1.01–1.65) | ||||||||||