ArticleCardiovascular diabetology2023
Improved prognosis with integrated care management including early rhythm control and healthy lifestyle modification in patients with concurrent atrial fibrillation and diabetes mellitus: a nationwide cohort study.
Article in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- Clinical outcomes of rate control versus rhythm control as the initial strategy in atrial fibrillation: insights from the GLORIA-AF registry.Internal and emergency medicine · 2026Article
- Decreased PLK2 promotes atrial fibrillation in diabetic mice through Nrf2/HO-1 pathway.Acta diabetologica · 2025Article
- Concomitant Diabetes and Atrial Fibrillation: Epicardial Fat and Macrophage-Related Mechanisms.Diabetes/metabolism research and reviews · 2025Review
- Genetically predicted dietary macronutrient intakes and atrial fibrillation risk: a Mendelian randomization study.European journal of medical research · 2024Article
- Utilization of Primary Healthcare Services in Patients with Multimorbidity According to Their Risk Level by Adjusted Morbidity Groups: A Cross-Sectional Study in Chamartín District (Madrid).Healthcare (Basel, Switzerland) · 2024Article
- Standardized community management on the diagnosis, treatment, and risk factors control for non-valvular atrial fibrillation in elderly patients.BMC primary care · 2023Article
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Authors and funding
7 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundPatients with concurrent atrial fibrillation (AF) and diabetes mellitus (DM) [AF-DM] have a high risk of cardiovascular and diabetes-related complications, but are less engaged in a comprehensive treatment approach. We evaluated the association of early rhythm control (ERC), lifestyle modification (LSM), and a combination of ERC and LSM with cardiovascular or diabetes-related complication risk in patients with AF-DM (type 2).
methodsFrom the National Health Information Database, 47,940 patients diagnosed with AF-DM in 2009-2016 were included. We defined ERC as rhythm control therapy within two years of AF diagnosis and LSM as adherence to ≥ 2 of the healthy behaviors among non-current smoking, non-drinking, and regular exercise. We compared the primary (ischemic stroke) and secondary (macro- and microvascular complications, glycemic emergency, and all-cause death) outcomes in four groups: non-ERC and non-LSM (group 1), LSM only (group 2), ERC only (group 3), and both ERC and LSM (group 4).
resultsOf total, 10,617 (22%), 26,730 (55.8%), 2,903 (6.1%), and 7,690 (16.0%) were classified into groups 1 to 4, in sequence. The mean duration from AF diagnosis to ERC was 25.6 ± 75.5 days. During 4.0 (interquartile range: 2.5-6.2) years' follow-up, groups 2 and 3 were associated with 23% and 33% lower risks of stroke than group 1, respectively. Group 4 was associated with the lowest risk of stroke: hazard ratio (HR) 0.58, 95% confidence interval (CI) 0.51-0.67, p < 0.001. Regarding secondary outcomes, the lowest risks were also observed in group 4; macro- and microvascular complications, glycemic emergency, and all-cause death had HRs (95% CIs) of 0.63 (0.56-0.70), 0.88 (0.82-0.94), 0.72 (0.62-0.84), and 0.80 (0.73-0.87), respectively, all p < 0.001.
conclusionsFor AF-DM patients, ERC and LSM exert a synergistic effect in preventing cardiovascular and diabetes-related complications with the greatest lowered risk of stroke. A comprehensive treatment approach should be pursued in AF-DM patients.
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