P5.27 PULSE PRESSURE IS A STRONG AND INDEPENDENT PREDICTOR OF INCIDENT ATRIAL FIBRILLATION IN TYPE 2 DIABETIC PATIENTS
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Introduction: Atrial fibrillation (AF) is the most common cause of chronic arrhythmia in adults and is associated with an increased risk of mortality and stroke. Pulse pressure (PP), as a surrogate measure of aortic stiffness, is an important risk factor for incident AF in the general adult population. Currently, there is no information about the possible role of PP in the development of FA in people with type 2 diabetes mellitus (DM), who are at high risk of developing FA.
Objective: we examined whether PP is associated with the development of incident AF in type 2 DM.
Methods: we followed for a mean period of 6.4 years an outpatient cohort of 350 subjects with type 2 DM, who regularly attended our diabetes clinic during the years 2001–2002 and who were free from AF at baseline (age 63±10 years, 43% women). Plasma lipids, hemoglobin A1c, diabetes duration, body mass index, blood pressure, current use of medications and other risk factors for AF were measured. Electrocardiograms were performed annually.
Results: During the follow-up, 32 patients (9.4%) developed incident AF. Baseline clinical and biochemical characteristics of participants stratified by PP tertiles are presented in Table 1. In multivariable logistic regression analyses, PP but not systolic or mean blood pressure was independently associated with an increased risk of incident AF (adjusted-OR 1.64 for each SD increment [12.8mmHg]; 95% CI, 1.09–2.50; P: 0.019).
Conclusions: PP is a strong and independent predictor of new-onset AF in patients with type 2 DM.
| Variables | I tertile PP <53 (n=116) | II tertile PP 53–60 (n=126) | III tertile PP ≥60 (n=108) | P value for trend |
|---|---|---|---|---|
| Gender (M/F) | 67/59 | 69/47 | 61/47 | 0.61 |
| Age (years) | 59±10 | 63±10 | 69±9 | <0.0001 |
| Body mass index (kg/m2) | 29.8±4 | 30.3±5 | 29.2±5 | 0.22 |
| Diabetes duration (years) | 5.5±1.1 | 5.9±1.0 | 6.3±0.9 | <0.0001 |
| Systolic pressure (mmHg) | 125±10 | 141±8 | 156±9 | <0.0001 |
| Diastolic pressure (mmHg) | 80±8 | 81±8 | 81±7 | 0.33 |
| Mean pressure (mmHg) | 95±8 | 101±8 | 106±7 | <0.0001 |
| Hemoglobin A1c (%) | 7.6±1.7 | 7.9±1.9 | 7.7±1.5 | 0.21 |
| Total cholesterol (mg/dl) | 205±37 | 202±41 | 204±38 | 0.79 |
| Creatinine (mg/dl) | 0.86±0.2 | 0.89±0.3 | 0.87±0.2 | 0.54 |
| Current smokers (n) | 32 | 28 | 22 | 0.058 |
| Obesity (n) | 52 | 59 | 40 | 0.29 |
| Hypertension (n) | 61 | 85 | 93 | <0.0001 |
| Chronic kidney disease (n) | 21 | 36 | 30 | 0.11 |
| Coronary heart disease (n) | 10 | 13 | 14 | 0.57 |
| Left ventricular hypertrophy (n) | 12 | 19 | 35 | <0.0001 |
| Chronic heart failure (n) | 1 | 3 | 4 | 0.33 |
| Valvular disease (n) | 1 | 2 | 1 | 0.85 |
| Incident atrial fibrillation (n) | 3 | 12 | 17 | <0.001 |
Cohort size, n=350. Data are expressed as means ± SD or absolute frequencies. P values for trends were determined by means of one-way ANOVA and chi-squared test (for categorical variables).
Baseline characteristics of the sample stratified by tertiles of pulse pressure.
Cite this article
TY - JOUR AU - F. Valbusa AU - S. Bonapace AU - G. Targher AU - L. Zenari AU - G. Arcaro PY - 2011 DA - 2011/11/29 TI - P5.27 PULSE PRESSURE IS A STRONG AND INDEPENDENT PREDICTOR OF INCIDENT ATRIAL FIBRILLATION IN TYPE 2 DIABETIC PATIENTS JO - Artery Research SP - 170 EP - 170 VL - 5 IS - 4 SN - 1876-4401 UR - https://doi.org/10.1016/j.artres.2011.10.082 DO - 10.1016/j.artres.2011.10.082 ID - Valbusa2011 ER -