ArticleCardiovascular diabetology2021
Higher long-term visit-to-visit glycemic variability predicts new-onset atrial fibrillation in patients with diabetes mellitus.
Article in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Glycemic variability and the risk of atrial fibrillation: a meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Atrial Fibrillation in Diabetes: Epidemiology, Mechanisms and Integrated Management.Journal of clinical medicine · 2026Review
- Association of glycemic variability with the risk of new-onset atrial fibrillation and death in critically ill patients without diabetes: analysis of the MIMIC-IV database.Diabetology & metabolic syndrome · 2026Article
- The role of stress hyperglycemia in in-hospital new-onset atrial fibrillation among patients with acute myocardial infarction: a narrative review.Frontiers in cardiovascular medicine · 2026Review
- The additive effect of hemoglobin glycation index and glycemic variability to predict mortality in cardiac intensive care patients with and without diabetes.Scientific reports · 2025Article
- Differential prognostic value of glycemic dysregulation markers in critically ill individuals with ischemic stroke, with and without diabetes.Diabetology & metabolic syndrome · 2025Article
- Association between glycemic variability in patients with traumatic lung injury and risk of in-hospital death: a retrospective analysis based on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.Journal of thoracic disease · 2025Article
- To explore the relationship between multiple glycemic markers and all-cause mortality in patients with severe atrial fibrillation based on multiple databases.Scientific reports · 2025Article
- Atrial Fibrillation in Diabetes: Pathogenesis and Targeted Rhythm Control Strategies.Current issues in molecular biology · 2025Review
- Clinical prediction study on the risk of atrial fibrillation in hypertensive patients based on metabolism, inflammation, and gender differences.Scientific reports · 2025Article
- Phenotypes of atrial fibrillation in a Taiwanese longitudinal cohort: Insights from an Asian perspective.Heart rhythm O2 · 2025Article
- Glucose metabolic dysregulation of diabetes and Its role in atrial fibrillation pathogenesis.Frontiers in cardiovascular medicine · 2025Review
- Review
- Article
- ECG abnormality and predictor of new-onset atrial fibrillation in hypertension and diabetes mellitus population: An observational analytic study from cardiovascular outpatient clinic at a National Cardiovascular Center in Indonesia.Journal of arrhythmia · 2023Article
- Dysglycemia and arrhythmias.World journal of diabetes · 2023Review
- Glycemic variability and in-hospital death of critically ill patients and the role of ventricular arrhythmias.Cardiovascular diabetology · 2023Article
- Prediabetes as a risk factor for new-onset atrial fibrillation: the propensity-score matching cohort analyzed using the Cox regression model coupled with the random survival forest.Cardiovascular diabetology · 2023Article
- In-hospital glycemic variability and all-cause mortality among patients hospitalized for acute heart failure.Cardiovascular diabetology · 2022Article
- Glycemic control and atrial fibrillation: an intricate relationship, yet under investigation.Cardiovascular diabetology · 2022Review
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5 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (T2DM). Glycemic variability (GV) is associated with risk of micro- and macrovascular diseases. However, whether the GV can increase the risk of AF remains unknown.
methodsThe cohort study used a database from National Taiwan University Hospital, a tertiary medical center in Taiwan. Between 2014 and 2019, a total of 27,246 adult patients with T2DM were enrolled for analysis. Each individual was assessed to determine the coefficients of variability of fasting glucose (FGCV) and HbA1c variability score (HVS). The GV parameters were categorized into quartiles. Multivariate Cox regression models were employed to estimate the relationship between the GV parameters and the risk of AF, transient ischemic accident (TIA)/ischemic stroke and mortality in patients with T2DM.
resultsThe incidence rates of AF and TIA/ischemic stroke were 21.31 and 13.71 per 1000 person-year respectively. The medium follow-up period was 70.7 months. In Cox regression model with full adjustment, the highest quartile of FGCV was not associated with increased risk of AF [Hazard ratio (HR): 1.12, 95% confidence interval (CI) 0.96-1.29, p = 0.148] or TIA/ischemic stroke (HR: 1.04, 95% CI 0.83-1.31, p = 0.736), but was associated with increased risk of total mortality (HR: 1.33, 95% CI 1.12-1.58, p < 0.001) and non-cardiac mortality (HR: 1.41, 95% CI 1.15-1.71, p < 0.001). The highest HVS was significantly associated with increased risk of AF (HR: 1.29, 95% CI 1.12-1.50, p < 0.001), total mortality (HR: 2.43, 95% CI 2.03-2.90, p < 0.001), cardiac mortality (HR: 1.50, 95% CI 1.06-2.14, p = 0.024) and non-cardiac mortality (HR: 2.80, 95% CI 2.28-3.44, p < 0.001) but was not associated with TIA/ischemic stroke (HR: 0.98, 95% CI 0.78-1.23, p = 0.846). The Kaplan-Meier analysis showed significantly higher risk of AF, cardiac and non-cardiac mortality according to the magnitude of GV (log-rank test, p < 0.001).
conclusionsOur data demonstrate that high GV is independently associated with the development of new-onset AF in patients with T2DM. The benefit of maintaining stable glycemic levels to improve clinical outcomes warrants further studies.
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