Disclosures: Bano reports no relevant financial disclosures. Reichlin reports receiving speaker/consulting honoraria or travel support from Abbott/St. Jude Medical, AstraZeneca, Brahms, Bayer, Biosense Webster, Biotronik, Boston Scientific, Bristol Myers Squibb/Pfizer, Daiichi Sankyo, Medtronic and Roche, and received support for his institution’s fellowship program from Abbott/St. Jude Medical, Biosense Webster, Biotronik, Boston Scientific and Medtronic, all for work outside the submitted study. Please see the study for all other authors’ relevant financial disclosures.
November 18, 2021
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Diabetes status decreases symptom perception for patients with AF

Disclosures: Bano reports no relevant financial disclosures. Reichlin reports receiving speaker/consulting honoraria or travel support from Abbott/St. Jude Medical, AstraZeneca, Brahms, Bayer, Biosense Webster, Biotronik, Boston Scientific, Bristol Myers Squibb/Pfizer, Daiichi Sankyo, Medtronic and Roche, and received support for his institution’s fellowship program from Abbott/St. Jude Medical, Biosense Webster, Biotronik, Boston Scientific and Medtronic, all for work outside the submitted study. Please see the study for all other authors’ relevant financial disclosures.
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In a cohort of patients with documented atrial fibrillation, those with diabetes were less likely to perceive AF symptoms than those without the disease, according to new research.

The findings also suggested patients with diabetes had worse quality of life and more comorbidities.

Diabetes General
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“This research can provide insights on improving the management of atrial fibrillation and prevention of its complications,” Tobias Reichlin, MD, professor of cardiology at the University of Bern in Switzerland, in a press release.

For the study, Reichlin, Arjola Bano, MD, PhD, postdoctoral research fellow at the University of Bern, and colleagues aimed to examine the relationship between diabetes status and AF phenotype and cardiac and neurological comorbidities in patients with documented AF. “Since diabetes is one of the major risk factors for AF, our team investigated whether patients with and without diabetes differ in terms of atrial fibrillation symptoms and complications,” Reichlin said in the release.

The researchers included participants from the multicenter Swiss-AF study with data on diabetes and AF phenotype. Parameters of AF phenotype, including AF type, AF symptoms and quality of life, served as the primary outcomes, whereas the secondary outcomes were cardiac and neurological comorbidities. Researchers determined the cross-sectional association of diabetes with these outcomes through logistic and linear regression, which they adjusted for age, sex and CV risk factors.

In all, the study featured 2,411 patients with AF (median age, 74 years), of whom 27% were women.

Results indicated that diabetes was not linked to nonparoxysmal AF (OR = 1.01; 95% CI, 0.81-1.27). Compared with patients without diabetes, those with diabetes were less likely to perceive AF symptoms (OR = 0.74; 95% CI, 0.59-0.92) and had a worse quality of life (beta = 4.54; 95% CI, 6.4 to 2.68).

In addition, patients with diabetes demonstrated an increased likelihood of having cardiac comorbidities, including hypertension (OR = 3.04; 95% CI, 2.19-4.22), MI (OR = 1.55; 95% CI, 1.18-2.03) and HF (OR = 1.99; 95% CI, 1.57-2.51), and neurological comorbidities such as stroke (OR = 1.39; 95% CI, 1.03-1.87) and cognitive impairment (OR = 1.75; 95% CI, 1.39-2.21).

“It is remarkable to find that patients with diabetes had a reduced recognition of atrial fibrillation symptoms,” Reichlin said in the release. “The reduced perception of atrial fibrillation symptoms may result in a delayed diagnosis of atrial fibrillation, and, consequently, more complications such as stroke. Our findings raise the question of whether patients with diabetes should be routinely screened for atrial fibrillation.”

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