Early Rhythm Control Reduces Mortality among Diabetes Patients with AF

In a recent study published in Diabetes Research and Clinical Practice found that early rhythm control (ERC) significantly impacts the occurrence of diabetes-related complications and mortality in subjects with type 2 diabetes mellitus (T2DM) and atrial fibrillation (AF).

The study included 47,509 subjects with T2DM and AF and based on the Korean National Health Insurance Service claims database spanning from 2009 to 2016. Subjects were divided into two groups – those who received ERC within one year of AF diagnosis and those who underwent usual care.

Among the participants (with a mean age of 66.7±10.5 years), 23.1% received ERC, while 76.9% received usual care. ERC was associated with a notable reduction in the risk of ischemic stroke, macrovascular and microvascular complications, and all-cause death. The adjusted hazard ratios were impressive: 0.77 [0.70–0.85], 0.79 [0.73–0.86], 0.86 [0.82–0.90], and 0.92 [0.87–0.98] respectively, with all p-values below 0.001, except for all-cause death which was 0.012.

The findings suggest that early rhythm control within one year of AF diagnosis, coupled with appropriate anticoagulation, could be a important strategy to prevent adverse outcomes for individuals with T2DM and AF. This holds significant promise for improving patient outcomes, not only by reducing the risk of stroke but also by mitigating both macro and microvascular complications associated with diabetes.

While these results are positive, further research is needed to explore the applicability and potential variations in different populations. Early rhythm control might emerge as a crucial element in enhancing the quality of care for these patients, emphasizing the need for a proactive approach in addressing both AF and diabetes.

Source: 

Lee, S.-R., Choi, J., Choi, E.-K., Lee, H., Han, M., Ahn, H.-J., Kwon, S., Lee, S.-W., Han, K.-D., Oh, S., & Y. H. Lip, G. (2023). Early rhythm control on diabetes-related complications and mortality in patients with type 2 diabetes mellitus and atrial fibrillation. In Diabetes Research and Clinical Practice (p. 111020). Elsevier BV. https://doi.org/10.1016/j.diabres.2023.111020