Evidence map›Paper›PMID 42329277›Full record

ArticleActa diabetologica2026

Glycemic control and clinical outcomes in patients with diabetes and atrial fibrillation: a nationwide cohort study.

Elis Kouki, Birgitta Salmela, Aapo Aro, Olli Halminen, Konsta Teppo, Leo Niskanen, Jari Haukka, Jukka Putaala, Miika Linna, Pirjo Mustonen and 3 more

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In one paragraph

Article in Acta diabetologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Elis KoukiUniversity of Helsinki, 00270, Helsinki, Finland. elis.kouki@helsinki.fi.ORCID http://orcid.org/0000-0002-5759-0916
Birgitta SalmelaDepartment of Internal Medicine, Heart Center, Päijät-Häme Central Hospital, Lahti, Finland.ORCID http://orcid.org/0009-0008-6801-0690
Aapo AroHeart and Lung Center, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0001-7030-6740
Olli HalminenUniversity of Eastern Finland, Kuopio, Finland.ORCID http://orcid.org/0000-0001-9266-8435
Konsta TeppoHeart Centre, Turku University Hospital, and University of Turku, Turku, Finland.ORCID http://orcid.org/0000-0002-4460-0994
Leo NiskanenDepartment of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland.ORCID http://orcid.org/0000-0003-1503-7060
Jari HaukkaUniversity of Helsinki, 00270, Helsinki, Finland.ORCID http://orcid.org/0000-0003-1450-6208
Jukka PutaalaDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0002-6630-6104
Miika LinnaUniversity of Eastern Finland, Kuopio, Finland.ORCID http://orcid.org/0000-0002-7660-2484
Pirjo MustonenTurku University Hospital, and University of Turku, Turku, Finland.ORCID http://orcid.org/0000-0003-1319-0248
Juha HartikainenKuopio University Hospital, and University of Eastern, Kuopio, Finland.ORCID http://orcid.org/0000-0003-0847-107X
K E Juhani AiraksinenTurku University Hospital, and University of Turku, Turku, Finland.ORCID http://orcid.org/0000-0002-0193-568X
Mika LehtoJorvi Hospital, Department of Internal Medicine, HUS Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.ORCID http://orcid.org/0000-0002-8691-5142

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo evaluate the association of HbA1c level at the time of atrial fibrillation (AF) diagnosis with adverse outcomes (death, ischemic stroke (IS), myocardial infarction (MI), bleeding) in an unselected nationwide cohort of patients with AF and diabetes mellitus (DM).

methodsThe retrospective FinACAF registry study covered all patients with incident AF in Finland between 2010 and 2017. Outcomes were analyzed using HRs and sHRs (hazard ratios and subdistribution hazard ratios), with HbA1c modelled both categorically and continuously.

resultsAmong 157 658 patients with incident AF, DM was present in 23% (n = 35 872). Baseline HbA1c was available in 49% (17 519) of DM patients. DM was associated with increased hazards of all evaluated outcomes. Elevated HbA1c in categorical analyses was associated with progressively increased adjusted HRs and sHRs, with highest ratios seen in HbA1c > 63 mmol/mol for death (HR 1.56, 95% CI 1.45-1.68), IS (sHR 1.38 95% CI 1.20-1.59), and MI (sHR 1.70 95% CI 1.48-1.94), when compared to patients without DM. In continuous analyses, higher HbA1c levels were associated with increasing hazards for mortality, IS, and MI. Bleeding hazards remained stable across the HbA1c spectrum.

conclusionsHigher baseline HbA1c levels were associated with progressively increased hazards of mortality, IS, and MI in patients with incident AF and DM.

Indexed as

Atrial FibrillationDiabetes MellitusGlycemic ControlAgedAged, 80 and overBlood GlucoseCohort StudiesFemaleFinlandGlycated HemoglobinHumansMaleMiddle AgedMyocardial InfarctionRegistriesRetrospective StudiesBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanAtrial fibrillationDiabetes mellitusGlycated hemoglobinIschemic strokeMortalityMyocardial infarction

Identifiers

PMID42329277
PMCPMC13469207

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.