| Description |
Type 2 diabetes mellitus (T2DM) is a well-known risk factor for atrial fibrillation (AF). The role of glycemic control in the development of AF is not clear in these patients. This study was conducted to find the association between glycemic control and AF in patients with T2DM receiving care through the US Veteran’s Affairs system. A case-control study was designed using US Veteran’s Affairs data in patients with T2DM receiving care between 2000 and 2014. The study included patients with T2DM as identified by diagnostic criteria or diabetes medication therapy, and with a minimum of two HbA1c values before the index date. Index date was defined as the AF diagnosis date for cases; for control patients, it was +/- 90 days of case’s index date. Incidence density sampling was used to select control patients who were matched with cases on diabetes duration and calendar year of T2DM diagnosis. Cases were defined as patients who were diagnosed with AF and controls were defined as patients who were not diagnosed with AF before the time period they were selected as control patients. A prior 12 month period before the index date was used to assess HbA1c values. HbA1C < 7% was defined as controlled glycemia. A logistic regression model was used to find the association between glycemic control and AF in patients with T2DM. After controlling for confounders, compared to patients who had a mean HbA1c < 7% in the preindex observation period, patients with mean HbA1c 7-9% were 0.94 times (95% CI 0.90, 0.99; p = 0.010), patients with HbA1c 9-11% were 0.95 times (95% CI 0.86, 1.04; p = 0.261) and patients with HbA1c > 11% were 0.96 times (95% CI, 0.81, 1.14; p = 0.642) as likely to be associated with AF. Numerous comorbidities were also associated with AF including congestive heart failure (OR: 2.29, 95% CI 2.20, 2.38; p < 0.001), coronary heart disease (OR: 1.72, 95% CI: 1.67, 1.78; p < 0.001), hypertension (OR: 2.03, 95% CI 1.96, 2.10; p < 0.001), myocardial infarction (OR: 1.97, 95% CI 1.80, 2.16; p < 0.001), left ventricular hypertrophy (OR: 1.51, 95% CI 1.38, 1.65; p < 0.001), and chronic kidney disease (OR: 1.14, 95% CI 1.09, 1.18; p < 0.001). We conclude that glycemic control is not associated with AF in patients with T2DM. |
