Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Nov;44(11):1602-1612.
doi: 10.1002/clc.23728. Epub 2021 Sep 21.

Risk stratification of cardiac arrhythmias and sudden cardiac death in type 2 diabetes mellitus patients receiving insulin therapy: A population-based cohort study

Sharen Lee  1 , Kamalan Jeevaratnam  2 , Tong Liu  3 , Dong Chang  4 , Carlin Chang  5 , Wing Tak Wong  6 , Ian Chi Kei Wong  7   8 , Gregory Y H Lip  9 , Gary Tse  2   3   10
Affiliations
Observational Study

Risk stratification of cardiac arrhythmias and sudden cardiac death in type 2 diabetes mellitus patients receiving insulin therapy: A population-based cohort study

Sharen Lee et al. Clin Cardiol. 2021 Nov.

Abstract

Introduction: Metabolic abnormalities may exacerbate the risk of adverse outcomes in patients with type 2 diabetes mellitus. The present study aims to assess the predictive value of HbA1c and lipid variability on the risks of sudden cardiac death (SCD) and incident atrial fibrillation (AF).

Methods: The retrospective observational study consists of type 2 diabetic patients prescribed with insulin, who went to publicly funded clinics and hospitals in Hong Kong between January 1, 2009 and December 31, 2009. Variability in total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglyceride, and HbA1c were assessed through their SD and coefficient of variation. The primary outcomes were incident (1) ventricular tachycardia/ventricular fibrillation, actual or aborted SCD and (2) AF.

Results: A total of 23 329 patients (mean ± SD age: 64 ± 14 years old; 51% male; mean HbA1c 8.6 ± 1.3%) were included. On multivariable analysis, HbA1c, total cholesterol, LDL-C and triglyceride variability were found to be predictors of SCD (p < .05).

Conclusion: HbA1c and lipid variability were predictive of SCD. Therefore, poor glucose control and variability in lipid parameters in diabetic patients are associated with aborted or actual SCD. These observations suggest the need to re-evaluate the extent of glycemic control required for outcome optimization.

Keywords: cardiac arrhythmias; sudden cardiac death; type 2 diabetes.

PubMed Disclaimer

Conflict of interest statement

No conflicts of interest.

Figures

FIGURE 1
FIGURE 1
(A) Kaplan–Meier survival curves of different age groups for sudden cardiac death. (B) Kaplan–Meier survival curves of different age groups for atrial fibrillation
See this image and copyright information in PMC

References

    1. Priori SG, Blomstrom‐Lundqvist C, Mazzanti A, et al. 2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the Management of Patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2015;36(41):2793‐2867. - PubMed
    1. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a global burden of disease 2010 study. Circulation. 2014;129(8):837‐847. - PMC - PubMed
    1. Ball J, Carrington MJ, McMurray JJ, Stewart S. Atrial fibrillation: profile and burden of an evolving epidemic in the 21st century. Int J Cardiol. 2013;167(5):1807‐1824. - PubMed
    1. Marijon E, Le Heuzey JY, Connolly S, et al. Causes of death and influencing factors in patients with atrial fibrillation: a competing‐risk analysis from the randomized evaluation of long‐term anticoagulant therapy study. Circulation. 2013;128(20):2192‐2201. - PubMed
    1. Benjamin EJ, Levy D, Vaziri SM, D'Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population‐based cohort. The Framingham heart study. Jama. 1994;271(11):840‐844. - PubMed

Publication types