Diabetes predicted atrial fibrillation prevalence, and incidence in women

Atrial fibrillation was 44% more prevalent and 38% more likely to develop when diabetes was present in an adult population — especially among women, according to recently published data.

Researchers assessed the prevalence and incidence of atrial fibrillation in 17,372 patients with diabetes and in the same amount of age- and sex-matched controls without type 2 diabetes included in a Kaiser Permanente Northwest diabetes registry. The researchers followed patients without atrial fibrillation for the comparison of atrial fibrillation incidence while controlling for known risk factors.

Data indicated that the prevalence for atrial fibrillation was significantly higher among patients with diabetes compared with those without (3.6% vs. 2.5%; P<.0001).

During a mean follow-up of 7.2 years, patients with diabetes without atrial fibrillation at baseline developed atrial fibrillation at an age- and sex-adjusted rate of 9.1 per 1,000 person-years vs. 6.6 per 1,000 person-years for patients without diabetes.

Diabetes was associated with a 26% increased risk for atrial fibrillation among women after adjusting for other risk factors (HR=1.26; 95% CI, 1.08-1.46). Diabetes was not a statistically significant risk factor among men.

Men had a higher prevalence of atrial fibrillation in all age groups regardless of diabetes; however, the difference in prevalence between those with diabetes vs. those without diabetes was greater in women. Atrial fibrillation was 30% more prevalent among men aged 65 to 74 years with diabetes (7.9% vs. 6.1%, P<.037), whereas the prevalence for atrial fibrillation was 61% higher in women with diabetes in the same age group (6.1% vs. 3.8%; P=.002).

“These findings have potential public health implications, especially in women, and emphasize the need for further investigation of the mechanistic links between diabetes and atrial fibrillation,” the researchers wrote.

Nichols GA. Diabetes Care. 2009;32:1851-1856.