Diabetes and atrial fibrillation – our century’s burden

Introduction: T he classical changes found in diabe-tic patients (interstitial atrial fibrosis and consecutive atrial dilatation) are known to be the main underlying causes blamed for the occurrence of atrial fibrillation in these patients. The substrate of this structural cardiac remodeling is probably due to a combination of factors that involve the chronic inflammatory process and oxi-dative stress.
Methods: A total of 257 patients admitted consecuti-vely in our clinic were evaluated during hospitalization and after discharge periodically. The patients included have atrial fibrillation and diabetes mellitus. The pati-ents were divided into 3 groups, depending on whether they have atrial fibrillation and/ or diabetes. The follow-up period of 2.6 years performed included surveillance. Blood tests were performed for a more accurate strati-fication.
Results: In our study, 88 (34.24%) patients have both diabetes and AF, 96 (37.35%) have AF and no diabetes, and 73 (28.40) patients have diabetes and no AF. Pati-ents with diabetes over 60 year of age have a high inci-dence of AF (84.43%). Once diabetes is compensated, 42 (16.34%) patients who revert spontaneously to sinus rhythm do so within 6.7 months of becoming compen-sated. Diabetes is recognized as a pro-inflammatory condition. The role of inflammation in the genesis of atrial fibrillation can not be neglected. Inflammation promotes electrical instability, but also structural re-modeling.
Conclusions: Diabetes increases cardiovascular risk in patients with atrial fibrillation, especially if the diabe-tic patient has a history of heart failure, hypertension, stroke, vascular disease or is often elderly. Diabetes mellitus is an independent risc factor in patients with atrial fibrillation.

ISSN
ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
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CNCSIS B+
CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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