{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T22:26:10Z","timestamp":1788128770776,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) and diabetes mellitus (DM) are both associated with adverse clinical events, but the associations have not been fully elucidated, particularly with concomitant insulin use. This study aimed to analyse the associations between adverse events and DM, as well as adverse events and sole insulin use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Our analysis included individuals with AF from the prospective Global Registry on Long\u2010Term Oral Anti\u2010Thrombotic Treatment in Patients with Atrial Fibrillation (GLORIA\u2010AF) registry with 3\u2010year follow\u2010up. Outcomes included all\u2010cause death, major bleeding, cardiovascular (CV) death, myocardial infarction (MI), stroke, thromboembolism and major adverse cardiovascular events (MACE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 15\u2009861 AF individuals were included (age 70.0\u2009\u00b1\u200910.2\u2009years; 55% male, 20% Asian), of whom, 3666 had DM (age 70.0 \u00b1\u20099.5\u2009years\u2009; 59% male, 21% Asian). After adjustment, those with DM had higher risks of all\u2010cause death (hazard ratio [HR]: 1.46, 95% confidence interval [CI]: 1.28\u20131.66), CV death (HR: 1.53 95% CI: 1.27\u20131.86), major bleeding (HR: 1.23, 95% CI: 1.01\u20131.48), MI (HR: 1.50, 95% CI: 1.17\u20131.94) and MACE (HR: 1.42, 95% CI: 1.23\u20131.63). Compared to individuals with DM receiving oral hypoglycaemic agents, those receiving insulin alone were associated with increased risks of all\u2010cause death (HR: 2.16, 95% CI: 1.61\u20132.91), CV death (HR: 2.24, 95% CI: 1.45\u20133.47), major bleeding (HR: 1.89, 95% CI: 1. 21\u20132.95), MI (HR: 2.24, 95% CI: 1.31\u20133.82) and MACE (HR: 2.11, 95% CI: 1.54\u20132.88).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DM was independently associated with higher risks of all\u2010cause death, CV death, MI, major bleeding and MACE in AF individuals. Individuals receiving insulin alone were associated with higher risks of all\u2010cause death, CV death, MI, major bleeding and MACE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15950","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T03:46:29Z","timestamp":1726803989000},"page":"5795-5804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diabetes mellitus and adverse clinical events in patients with atrial fibrillation: A report from the\n                    <scp>GLORIA<\/scp>\n                    \u2010\n                    <scp>AF<\/scp>\n                    registry phase\n                    <scp>III<\/scp>"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4430-3452","authenticated-orcid":false,"given":"Yang","family":"Liu","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Department of Cardiovascular Medicine The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven H. M.","family":"Lam","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bi","family":"Huang","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Department of Cardiology The First Affiliated Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-8942","authenticated-orcid":false,"given":"Giulio F.","family":"Romiti","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Department of Translational and Precision Medicine Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uazman","family":"Alam","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Institute of Life Course and Medical Sciences, University of Liverpool  Liverpool UK"},{"name":"Department of Medicine University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Aintree Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Clinical Medicine, and Cardiovascular Research Centre, National Yang\u2010Ming University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Olshansky","sequence":"additional","affiliation":[{"name":"Division of Cardiology The University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University  Nanchang China"},{"name":"Department of Genetic Medicine The Second Affiliated Hospital of Nanchang University, Jiangxi Medical College, Nanchang University  Nanchang China"},{"name":"Jiangxi Key Laboratory of Molecular Medicine  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno V.","family":"Huisman","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Thrombosis and Haemostasis Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. 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