Prevalence of Atrial Fibrillation and Its Clinical Outcomes Among Patients With Type 2 Diabetes and NASH

Type 2 diabetes (T2DM) and nonalcoholic steatohepatitis (NASH) are associated with increased cardiovascular disease and are independent risk factors for atrial fibrillation (AF). We aimed to evaluate the prevalence of AF and its impact on clinical outcomes and overall healthcare burden among patient...

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Bibliographic Details
Published in:The American heart journal 2021-12, Vol.242, p.166-166
Main Authors: Pereira, Leanne, Fatuyi, Michael, Namdarizandi, Vahid, Elabidin, Awfa Zain, Sharma, Vivek, Shemisa, Kamal
Format: Article
Language:English
Subjects:
Arteriosclerosis
Atherosclerosis
Biomarkers
Cardiac arrhythmia
Cardiovascular diseases
Clinical outcomes
Congestive heart failure
Cost analysis
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diagnosis
Fibrillation
Health risks
Hospital costs
Hypertrophy
Mortality
Patients
Regression analysis
Risk analysis
Risk factors
Ventricle
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Summary:Type 2 diabetes (T2DM) and nonalcoholic steatohepatitis (NASH) are associated with increased cardiovascular disease and are independent risk factors for atrial fibrillation (AF). We aimed to evaluate the prevalence of AF and its impact on clinical outcomes and overall healthcare burden among patients with concomitant T2DM and NASH. We queried the 2017-2018 National Inpatient Sample (NIS) for adult patients hospitalized with T2DM with history of NASH as principal diagnosis, with and without AF as a secondary diagnosis. The primary outcome was inpatient mortality, while secondary outcomes were cardiac arrest, heart failure (HF), length of stay, and total hospital cost. Multivariable logistic regression analysis was applied to estimate clinical outcome. 3,930 patients with T2DM and NASH were admitted; of which 9.3% had AF. AF vs No AF cohorts were mean age of 66.8 years [CI 64.5-69.0] vs 57 years [CI 56.3-58.3]; males (53.4% vs 37.9%); white (80.2% vs 72.0%), black (8.5% vs 8.6%), and Hispanic (8.5% vs 14%). Compared to the No AF cohort, patients with AF had a higher prevalence of HF (41.1% vs 16.55%; p=0.017). There were no significant difference in other outcomes measured between cohorts (Table 1). Our results show that AF in patients with underlying T2DM and NASH is associated with a higher prevalence of HF but not mortality. Possible reasons for more prevalent HF include a greater burden of atherosclerosis, ventricular hypertrophy, left atrial remodeling and pericardial fat deposition. Further investigation into specific biomarkers may help predict individuals at risk for HF.
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2021.10.052