Type 1 diabetes independent risk factor for atrial fibrillation

This systematic review and meta-analysis of four cohort studies examined the association between type 1 diabetes and atrial fibrillation risk. Pooled results indicated that patients with type 1 diabetes had a higher AF risk than the control group. The risk was higher in female patients compared with male patients and in patients, younger than 65 years compared with those older than 65.

Atrial fibrillation and diabetes are common pathological conditions in cardiology. Also, their association is frequent; about 15% of diabetes patients have atrial fibrillation, and approx 30% of AF cases occur in diabetes patients.

Diabetes is an independent risk factor for AF, and co-existing atrial fibrillation is a co-morbidity – a risk factor for the evolution of the diabetes patient.

The association of AF with DM is a situation that enables a holistic approach to AF with patient-centred management and corresponds to the recommendations of the 2020 ESC Guideline for AF's diagnosis and management.

Against the above background, Siyu Guo, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, PR China, and colleagues aimed to elaborate on the association between type 1 diabetes mellitus and the risk of atrial fibrillation in a meta-analysis.

For this purpose, the researchers systematically searched the online databases up to August 2022 for studies related to type 1 diabetes and incidence of atrial fibrillation. The meta-analysis included a total of four cohort studies. Each study's hazard ratios (HRs) were pooled via a random-effects model.

The study led to the following findings:

• Pooled results suggested that type 1 diabetes patients had a higher AF risk (HR = 1.30) than the control group.
• The subgroup analysis found a higher AF incidence in female T1DM patients (HR = 1.50) than in male patients.
• Compared with T1DM patients over 65, those with < 65 years showed an increased risk of AF (HR = 1.45).

Our meta-analysis demonstrated that T1DM was an independent risk factor for AF development, but further studies should be performed to provide more convincing evidence.