Atrial Fibrillation With Diabetes: Risk for Cardiovascular Events in Women vs Men
After age, comorbidities, and medication adjustments, female sex was associated with a higher risk for mortality in patients with afib and diabetes. Image credit: Science Source
|This article is part of Endocrinology Advisor's coverage of the 53rd European Association for the Study of Diabetes (EASD) Annual Meeting taking place in Lisbon, Portugal. Check back regularly for more news on the latest clinical research in bone health from EASD 2017.|
Women with atrial fibrillation (AF) and diabetes have higher rates for mortality as well as cardiovascular events compared with men, according to a study presented at the 53rd European Association for the Study of Diabetes (EASD) Annual Meeting, held September 11-15, 2017, in Lisbon, Portugal.
A total of 180,861 men and 145,971 women with nonvalvular AF were included in the study and followed up for a median of 3.7 years. Data showed that 18.6% of men and 16.7% of women had diabetes.
Mortality occurred in 45.8% of men vs 53% of women (P <.001), while heart failure occurred in 21.6% of men vs 21% of women (P =.062). Women also experienced higher rates of ischemic stroke (9.6% vs 7.2%; P <.001) and myocardial infarction (MI; 7.6% vs 7.1%; P =.028). Men had slightly higher rates of bleeding (6.6% vs 5.9%; P =.001).
Female sex was associated with a lower risk for mortality when adjusted for age, comorbidities, and medication (hazard ratio [HR], 0.77; 95% CI, 0.75-0.79). The same trend was true for combined events (first of mortality, heart failure, ischemic stroke, or MI; HR, 0.82; 95% 0.80-0.84). Ischemic stroke was the exception; female sex was still associated with a higher risk (HR, 1.08; 95% CI, 1.01-1.16).
Compared with the general population, the standardized mortality ratio was 1.85 (95% CI, 1.78-1.92) for men with AF and diabetes and 2.04 (95% CI, 1.96-2.13) for women with AF and diabetes. Anticoagulation was used in approximately 51% of men and 42% of women.
The researchers concluded that women with AF and diabetes have higher event rates for ischemic stroke, MI, and mortality compared with men, and that the lower rates for bleeding and heart failure did not reach statistical significance. After adjustments, however, the risk for many cardiovascular complications was lower in women vs men, except for stroke.
Karayiannides S, Lundman P, Friberg L, Norhammar A. Prognostic differences in men and women with atrial fibrillation and diabetes: a nationwide report. Presented at: 53rd European Association for the Study of Diabetes Annual Meeting; September 11-15, 2017; Lisbon, Portugal. Abstract 1161.