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

Lee, So-Ryoung; Ahn, Hyo-Jeong; Choi, Eue-Keun; Lee, Seung-Woo; Han, Kyung-Do; Oh, Seil; Lip, Gregory Y. H.

doi:10.1186/s12933-023-01749-z

Cardiovascular Diabetology

Table 2 Event numbers, crude incidence rates, hazard ratios for the risk of stroke, diabetes-related complications, and death according to the combination of early rhythm control and healthy lifestyle

From: 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

	Number	Event	IR	Model 1 HR (95% CI)	Model 2 (HR 95% CI)	Model 3 (HR 95% CI)
Primary outcome: Stroke
Group 1	10,617	622	1.34	1 (reference)	1 (reference)	1 (reference)
Group 2	26,730	1678	1.47	1.098 (1.001–1.204)	0.824 (0.745–0.912)	0.769 (0.694–0.851)
Group 3	2903	114	0.96	0.714 (0.585–0.872)	0.748 (0.613–0.913)	0.670 (0.548–0.819)
Group 4	7690	364	1.18	0.878 (0.771–0.999)	0.697 (0.609–0.797)	0.581 (0.507–0.667)
p-value				< 0.001	< 0.001	< 0.001
Secondary outcomes
Macrovascular complications
Group 1	10,617	936	2.06	1 (reference)	1 (reference)	1 (reference)
Group 2	26,730	2420	2.16	1.049 (0.972–1.131)	0.857 (0.790–0.931)	0.794 (0.731–0.863)
Group 3	2903	182	1.56	0.752 (0.642–0.882)	0.783 (0.668–0.917)	0.708 (0.604–0.831)
Group 4	7690	554	1.83	0.883 (0.795–0.981)	0.753 (0.675–0.839)	0.625 (0.559–0.698)
p-value				< 0.001	< 0.001	< 0.001
Microvascular complications
Group 1	10,617	2195	5.38	1 (reference)	1 (reference)	1 (reference)
Group 2	26,730	6478	6.70	1.225 (1.167–1.286)	1.082 (1.026–1.141)	1.001 (0.949–1.055)
Group 3	2903	465	4.33	0.792 (0.717–0.876)	0.804 (0.727–0.888)	0.830 (0.751–0.918)
Group 4	7690	1547	5.78	1.034 (0.969–1.104)	0.932 (0.871–0.998)	0.875 (0.816–0.937)
p-value				< 0.001	< 0.001	< 0.001
Glycemic emergency
Group 1	10,617	472	1.00	1 (reference)	1 (reference)	1 (reference)
Group 2	26,730	1439	1.25	1.249 (1.126–1.386)	0.904 (0.807–1.014)	0.802 (0.715–0.900)
Group 3	2903	87	0.73	0.728 (0.579–0.915)	0.762 (0.606–0.957)	0.772 (0.613–0.971)
Group 4	7690	327	1.06	1.061 (0.922–1.222)	0.813 (0.702–0.942)	0.720 (0.620–0.836)
p-value				< 0.001	0.013	< 0.001
All-cause death
Group 1	10,617	1340	2.79	1 (reference)	1 (reference)	1 (reference)
Group 2	26,730	4443	3.77	1.351 (1.271–1.436)	0.985 (0.923–1.052)	0.896 (0.839–0.957)
Group 3	2903	256	2.11	0.760 (0.665–0.868)	0.825 (0.722–0.944)	0.839 (0.733–0.959)
Group 4	7690	970	3.08	1.109 (1.021–1.204)	0.877 (0.806–0.955)	0.801 (0.734–0.873)
p-value				< 0.001	< 0.001	< 0.001

IR, per 100 person-years
Model 1: unadjusted
Model 2: age and sex adjusted
Model 3: age, sex, CHA₂DS₂-VASc score, Charlson comorbidity index, duration of diabetes, hypertension, dyslipidemia, heart failure, prior ischemic stroke, myocardial infarction, peripheral artery disease, chronic obstructive pulmonary disease, cancer, chronic liver disease, chronic kidney disease, osteoporosis, hyperthyroidism, hypothyroidism, sleep apnea, low income, body mass index, systolic blood pressure, fasting glucose, oral anticoagulation therapy, antiplatelet agents, statin, angiotensin-converting enzyme inhibitor/ angiotensin receptor blocker, beta-blocker, non-dihydropyridine calcium channel blocker, dihydropyridine calcium channel blocker, diuretics, digoxin, types and numbers of diabetes medications were adjusted
CI confidence interval, HR hazard ratio, IR incidence rate

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ISSN: 1475-2840

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