EN | TR
E-ISSN: 1307-5608
The Role of CHA<sub>2</sub>DS<sub>2</sub>VASC Score and Diabetes-Related Demographic and Clinical Factors for Determining the İncidence of Paroxysmal Atriyal Fibrillation in 24 Hour Rhythm Monitoring in Patients with Type 2 Diabetes Mellitus
PDF
Cite
Share
Request
Research Article
VOLUME: 71 ISSUE: 3
P: 200-206
December 2018

The Role of CHA2DS2VASC Score and Diabetes-Related Demographic and Clinical Factors for Determining the İncidence of Paroxysmal Atriyal Fibrillation in 24 Hour Rhythm Monitoring in Patients with Type 2 Diabetes Mellitus

J Ankara Univ Fac Med 2018;71(3):200-206
DOI: 10.4274/atfm.70299
Orçun Çiftçi 1
Suzan Keskin 1
Lala Ramazanova 2
Özlem Turhan İyidir 2
Yusuf Bozkuş 2
Kerem Can Yılmaz 1
Emir Karaçağlar 1
Mustafa Yılmaz 1
Neslihan Başçıl Tütüncü 2
Mehmet Bülent Özin 1
İbrahim Haldun Müderrisoğlu 1
1. Başkent Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Ankara, Türkiye
2. Başkent Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Endokrinoloji ve Metabolizma Bilim Dalı, Ankara, Türkiye
No information available.
No information available
Received Date: 05.11.2018
Accepted Date: 05.11.2018
Publish Date: 26.03.2019
PDF
Cite
Share
Request

ABSTRACT

Objectives:

Diabetes mellitus is a risk factor for atrial fibrillation and thromboembolism. CHA2DS2VASC score is a scoring system indicating risk of thromboembolism in atrial fibrillation. As it also includes risk factors for atrial fibrillation, it may also indicate a heightened atrial fibrillation risk. Herein, we investigated the role of CHA2DS2VASC score and diabetes-related factors for determining paroxysmal atrial fibrilallation incidence in 24-hour rhythm monitorization among type 2 diabetic patients.

Materials and Methods:

We retrospectively analyzed type 2 diabetic patients older than 18 years of age who underwent 24-hour rhythm monitoring at Başkent University, Faculty of Medicine, Department of Cardiology between January 2012 and January 2017. The patients’ CHA2DS2VASC scores, clinical and demographic parameters, and transthoracic echocardiography findings were recorded. The correlations between paroxysmal atrial fibrillation and study parameters was analyzed. Multivariate analysis was used to determine significant independent predictors of atrial fibrillation. ROC analysis were done to determine the best cut-off points for significant predictors of atrial fibrillation.

Results:

A total of 65 (17.2%) of 378 patients had atrial fibrillation in 24-hour rhythm monitoring. The patients with atrial fibrillation had a significantly greater CHA2DS2VASC score. The patients with atrial fibrillation were significantly older, had a longer diabetes duration, and a larger left atrium. Age, diabetes duration, CHA2DS2VASC score, and left atrial diameter were significantly correlated with atrial fibrillation while CHA2DS2VASC score was a significant independent predictor of paroxysmal atrial fibrillation in 24-hour rhythm monitoring. The patients with a CHA2DS2VASC score of equal to or greater than 3 had a significantly greater incidence of paroxysmal atrial fibrillation.

Conclusion:

Among type 2 diabetics, CHA2DS2VASC score is a significant predictor of atrial fibrillation in 24-hour rhythm monitoring. Atrial fibrillation should be suspected in type 2 diabetics with a high CHA2DS2VASC score. Randomized controlled studies are needed in this field.

Keywords: Atrial Fibrillation, Diabetes Mellitus, 24 Hour Rhythm Monitorization, CHA2DS2VASC Score

References

1
Benjamin EJ, Levy D, Vaziri SM, et al. Independent risk factors for atriyal fibrillation in a population-based cohort. The Framingham Heart Study. JAMA. 1994;271:840.
2
Devereux RB, Roman MJ, Paranicas M, et al. Impact of diyabetes on cardiac structure and function: the strong heart study. Circulation. 2000;101:2271.
3
Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atriyal fibrillation using a novel risk factor-based approach: the euro heart survey on atriyal fibrillation. Chest. 2010;137:263-272.
4
Lodder J, Bamford JM, Sandercock PA, et al. Are hypertension or cardiac embolism likely causes of lacunar infarction? Stroke. 1990;21:375-381.
5
Enis J. Stroke prevention in patients with non-valvular atriyal fibrillation: a current community perspective. Journal of Clinical Neuroscience Volume 4, Issue 3, July 1997, Pages 320-325.
6
Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines forthe management of atriyalfibrillation developed in collaboration with EACTS. Europace. 2016;18:1609-1678.
7
Barkas F, Elisaf M, Korantzopoulos P, et al. The CHADS2 and CHA2DS2-VASc scores predict atriyal fibrillation in dyslipidemic individuals: Role of incorporating low high-density lipoprotein cholesterol levels. Int J Cardiol. 2017;241:194-199.
8
Saliba W, Gronich N, Barnett-Griness O, et al. Usefulness of CHADS2 and CHA2DS2-VASc Scores in the Prediction of New-Onset AtriyalFibrillation: A Population-Based Study. Am J Med. 2016;129:843-849.
9
Zuo ML, Liu S, Chan KH, et al. The CHADS2 and CHA2DS2VASc scorespredict new occurrence of atriyalfibrillation and ischemic stroke. J Interv Card Electrophysiol. 2013;37:47-54.
10
Baturova MA, Lindgren A, Carlson J, et al. Predictors of new onset atriyal fibrillation during 10-year follow-up after first-ever ischemic stroke. Int J Cardiol. 2015;199:248-252.
11
Lévy S. Factors predisposing to the development of atriyal fibrillation. Pacing Clin Electrophysiol. 1997;20:2670-2674.
12
Krahn AD, Manfreda J, Tate RB, et al. The natural history of atriyal fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. Am J Med. 1995;98:476-484.
13
Chugh SS, Blackshear JL, Shen WK, et al. Epidemiology and natural history of atriyal fibrillation: clinical implications. J Am Coll Cardiol 2001;37:371.
14
Feinberg WM, Blackshear JL, Laupacis A, et al. Prevalence, age distribution, and gender of patients with atriyal fibrillation. Analysis and implications. Arch Intern Med. 1995;155:469.
15
Heeringa J, van der Kuip DA, Hofman A, et al. Prevalence, incidence and lifetime risk of atriyal fibrillation: the Rotterdam study. Eur Heart J. 2006;27:949.
16
Santhanakrishnan R, Wang N, Larson MG, et al. Atriyal Fibrillation Begets Heart Failure and Vice Versa: Temporal Associations and Differences in Preserved Versus Reduced Ejection Fraction. Circulation. 2016;133:484.
17
Crenshaw BS, Ward SR, Granger CB, et al. Atriyal fibrillation in the setting of acute myocardial infarction: the GUSTO-I experience. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries. J Am Coll Cardiol. 1997;30:406.
18
Wong CK, White HD, Wilcox RG, et al. New atriyal fibrillation after acute myocardial infarction independently predicts death: the GUSTO-III experience. Am Heart J. 2000;140:878.
19
Eldar M, Canetti M, Rotstein Z, et al. Significance of paroxysmal atriyal fibrillation complicating acute myocardial infarction in the thrombolytic era. SPRINT and Thrombolytic Survey Groups. Circulation. 1998;97:965.
2024 ©️ Galenos Publishing House