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Management of atrial fibrillation in diabetes
Author(s) -
Dobbin Stephen,
Fisher Miles,
McKay Gerry
Publication year - 2018
Publication title -
practical diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.205
H-Index - 24
eISSN - 2047-2900
pISSN - 2047-2897
DOI - 10.1002/pdi.2155
Subject(s) - atrial fibrillation , medicine , diabetes mellitus , cardiology , heart disease , heart failure , intensive care medicine , endocrinology
Diabetes is an important risk factor for cardiovascular morbidity and mortality, and atrial fibrillation is linked to cardiovascular complications. The prevalence of both is increasing and they commonly co‐exist with a longer duration of diabetes and poorer control putting individuals at higher risk of atrial fibrillation. The complications of atrial fibrillation include heart failure and thromboembolism. There is an association between diabetes and atrial fibrillation and there are many theories as to the specific pathophysiology, including sharing similar precursors, but it is not clearly understood. What is understood is that the risk of developing the main consequences of atrial fibrillation can be reduced by treatment. Broadly speaking, this involves controlling the heart rhythm and/or heart rate to improve cardiac function in addition to anticoagulation. The development of risk stratification strategies and direct oral anticoagulants has led to safer anticoagulation with more individuals thought to benefit balanced against any potential risk of bleeding. The evidence base for treatment of atrial fibrillation includes many individuals with diabetes and, in this group, prevention of complications is equally as relevant. In those with diabetes and atrial fibrillation the evidence overwhelmingly supports a treatment strategy similar to that for individuals with atrial fibrillation but without diabetes. This should be done in addition to identifying and treating other cardiovascular risk factors. Copyright © 2018 John Wiley & Sons.