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