Highlights
- •Women with T2DM had 1.33 higher incidence of AF compared to T2DM men.
- •Women were older, had more obesity, hypertension and higher CHA2DS2-VASc score.
- •Ablation and implanted pacemakers were less frequently used in diabetic women.
- •After multivariable adjustment sex did not predict mortality during admissions for AF.
Abstract
Background
We reviewed trends from 2004 to 2013 in the incidence and outcomes for atrial fibrillation
(AF) in Spanish patients with type 2 diabetes mellitus (T2DM) comparing women and
men.
Methods
We used national hospital discharge data including all T2DM patients discharged from
the hospital after AF. Patients with AF in the primary diagnosis field were selected.
Discharges were grouped by sex. Incidence was calculated overall and stratified by
sex. We analyzed diagnostic and therapeutic procedures, patient comorbidities, CHA2DS2-VASc
score, length of hospital stay, readmission rates and in-hospital mortality (IHM).
Results
We identified a total of 214,457 admissions for AF. Patients with T2DM accounted for
21.1% (19,505 men and 25,954 women). Women with T2DM had a significantly higher incidence
of AF compared to men over the study period (IRR 1.33;95%CI 1.31–1.35). Women were
significantly older (77.24 ± 8.69 years) than men (72.62 ± 10.28 years), had higher prevalences of obesity and hypertension, and higher CHA2DS2-VASc
score. Women less frequently underwent ablation (3.21% vs. 1.54%; p < 0.001) and received an implanted pacemaker (14.3% vs. 8.16%; p < 0.001) than men. Crude IHM was 2.81% for women and 2.48% for men (p = 0.030). Sex was not associated with a higher IHM after multivariable adjustment.
Conclusions
Our study demonstrates an increase in hospitalization for AF in diabetic women. Women
were older, had a higher comorbidity index and had CHAD2DS2-VASc score than men. Women
with AF and T2DM undergo ablation or pacemaker implantation less frequently than their
male counterparts. After multivariable adjustment sex did not predict mortality during
admissions for AF.
Keywords
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Article info
Publication history
Published online: May 12, 2017
Accepted:
May 8,
2017
Received in revised form:
February 20,
2017
Received:
October 21,
2016
Identification
Copyright
© 2017 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
