| الوصف: |
Background Compared to people without diabetes, people with type 2 diabetes mellitus (T2DM) have an increased risk of developing atrial fibrillation (AF). Possible predictors of AF have not been adequately investigated in T2DM. We aimed to identify the factors associated with AF in such patients. Methods A total of 2,682 patients with T2DM, who was admitted to Department of Cardiovascular Medicine, the Third Affiliated Hospital, Sun Yat-sen University between 1 June, 2015 to 1 Nov, 2019, were enrolled in the study. 641 patients were excluded. There were 122 patients with AF and 1,919 patients without AF. 1:1 propensity scores match was performed according to age and gender. Patients were divided into the two groups: with AF (122patients) and without AF (122patients). Clinical, demographic, echocardiographic, laboratorial data and medicine were compared between the groups. Results There was significant statistical difference in neutrophil, monocyte, creatinine, total cholesterol (TC), triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), apolipoprotein B100 (ApoB100), monocyte to high-density lipoprotein ratio (MHR), fasting glucose (FG), left atrial diameter (LAD), ejection fraction(EF), antiplatelet therapy and the prevalence of heart failure between the two groups. On multivariate logistic regression analysis, the increase of MHR, FG and LAD, as well as the decrease of TC and antiplatelet therapy were independent predictors of AF. On receiver operating characteristic (ROC) curve analysis, using a cut-off level of 0.568, MHR predicted AF with a sensitivity of 65.6%, a specificity of 76.2%, and an AUC of 0.736(95% CI 0.673-0.800). Using a cut-off level of 0.507, the combination of TC, MHR, FG, LAD and antiplatele therapy predicted AF with a sensitivity of 73.0%, a specificity of 84.4%, and an AUC of 0.862(95% CI 0.816-0.907). Conclusions The increase of MHR, FG and LAD, as well as the decrease of TC and antiplatelet therapy were independent predictors of AF. MHR only, as well as the combination of TC, MHR, FG, LAD and antiplatelet therapy can better predict the risk of AF in patients with T2DM. |
