{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:13:19Z","timestamp":1783577599172,"version":"3.55.0"},"reference-count":47,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer and Bristol Myers Squibb (BMS)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Aims. To evaluate the adverse events (and its clinical correlates) in a large prospective cohort of Asian patients with atrial fibrillation (AF) and diabetes mellitus (DM). Material and Methods. We recruited patients with atrial fibrillation (AF) from the Asia-Pacific Heart Rhythm Society (APHRS) AF Registry and included those for whom the diabetic mellitus (DM) status was known. We used Cox-regression analysis to assess the 1-year risk of all-cause death, thromboembolic events, acute coronary syndrome, heart failure and major bleeding. Results. Of 4058 patients (mean age 68.5 \u00b1 11.8 years; 34.4% females) considered for this analysis, 999 (24.6%) had DM (age 71 \u00b1 11 years, 36.4% females). Patients with DM had higher mean CHA2DS2-VASc (2.3 \u00b1 1.6 vs. 4.0 \u00b1 1.5, p &lt; 0.001) and HAS-BLED (1.3 \u00b1 1.0 vs. 1.7 \u00b1 1.1, p &lt; 0.001) risk scores and were less treated with rhythm control strategies compared to patients without DM (18.7% vs. 22.0%). After 1-year of follow-up, patients with DM had higher incidence of all-cause death (4.9% vs. 2.3%, p &lt; 0.001), cardiovascular death (1.3% vs. 0.4%, p = 0.003), and major bleeding (1.8% vs. 0.9%, p = 0.002) compared to those without DM. On Cox regression analysis, adjusted for age, sex, heart failure, coronary and peripheral artery diseases and previous thromboembolic event, DM was independently associated with a higher risk of all-cause death (HR 1.48, 95% CI 1.00\u20132.19), cardiovascular death (HR 2.33, 95% CI 1.01\u20135.40), and major bleeding (HR 1.91, 95% 1.01\u20133.60). On interaction analysis, the impact of DM in determining the risk of all-cause death was greater in young than in older patients (p int = 0.010). Conclusions. Given the high rates of adverse outcomes in these Asian AF patients with DM, efforts to optimize the management approach of these high-risk patients in a holistic or integrated care approach are needed.<\/jats:p>","DOI":"10.3390\/jcm13051274","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T07:33:56Z","timestamp":1708673636000},"page":"1274","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Adverse Events and Clinical Correlates in Asian Patients with Atrial Fibrillation and Diabetes Mellitus: A Report from Asia Pacific Heart Rhythm Society Atrial Fibrillation Registry"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2895-6234","authenticated-orcid":false,"given":"Tommaso","family":"Bucci","sequence":"first","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK"},{"name":"Department of General and Specialized Surgery, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0777-8048","authenticated-orcid":false,"given":"Katarzyna","family":"Nabrdalik","sequence":"additional","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK"},{"name":"Department of Internal Diseases, Diabetology and Nephrology in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0594-8576","authenticated-orcid":false,"given":"Alena","family":"Shantsila","sequence":"additional","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-8942","authenticated-orcid":false,"given":"Giulio Francesco","family":"Romiti","sequence":"additional","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK"},{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wee-Siong","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre, Singapore 610041, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung-Wook","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-8973","authenticated-orcid":false,"given":"Wataru","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nippon Medical School, Tokyo 113-8602, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Fat","family":"Tse","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, School of Clinical Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR 999077, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-2478","authenticated-orcid":false,"given":"Marco","family":"Proietti","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"},{"name":"Division of Subacute Care, IRCCS Institute Clinici Scientifici Maugeri, 20138 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze-Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan"},{"name":"Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L7 8TX, UK"},{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Asia-Pacific Heart Rhythm Society Atrial Fibrillation Registry Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1747493019897870","article-title":"Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge","volume":"16","author":"Lippi","year":"2021","journal-title":"Int. J. 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