Diabetes mellitus is a strong, independent risk for atrial fibrillation and flutter in addition to other cardiovascular disease

Int J Cardiol. 2005 Dec 7;105(3):315-8. doi: 10.1016/j.ijcard.2005.02.050.


Background: Diabetes mellitus (DM) is a major risk factor for atherosclerosis. There is a controversy in literature about correlation between DM and atrial fibrillation. The goal of this study was to evaluate DM as a risk factor for atrial fibrillation or flutter using a very large database.

Method: Patient treatment files (PTF) containing discharge diagnoses were utilized using ICD-9 codes of inpatient treatment from Veterans Health Administration Hospitals (VAH). Patients with type II DM (ICD-9 code 250.0) (293,124) discharged from the VAH between 1990 and 2000. Non-matched controls without DM but with hypertension (552,624) were selected from the same PTF. By using multi-variate logistic regressions, the occurrence of atrial fibrillation, atrial flutter, CHF, CAD and LVH was compared.

Results: Atrial fibrillations occurred in 43,674 (14.9%) DM patients vs. 57,077 (10.3%) in the control group (p<0.0001). Atrial flutter occurred in 11,852 (4%) of DM patients vs. 13,554 (2.5%) of the control group (p<0.0001). Using multi-variant analysis, DM remained independently associated with atrial fibrillation with an OR of 2.13, (95% CI: 2.10 to 2.16; p<0.0001) and flutter (OR 2.20, CI: 2.15 to 2.26; p<0.0001). Furthermore, CHF (OR 3.12, CI: 3.09 to 3.16; p<0.0001), LVH (OR 1.85, CI: 1.77 to 1.92; p<0.0001) and CAD (OR 2.39, CI: 2.34 to 2.44; p<0.0001) were also independently associated with DM.

Conclusion: This is the first large-scale study finding DM as a strong, independent risk for the occurrence of atrial fibrillation and flutter and other cardiovascular disease.

MeSH terms

  • Aged
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / etiology
  • Atrial Flutter / epidemiology*
  • Atrial Flutter / etiology
  • Case-Control Studies
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / etiology
  • Diabetes Complications / epidemiology*
  • Female
  • Heart Failure / epidemiology
  • Heart Failure / etiology
  • Humans
  • Hypertrophy, Left Ventricular / epidemiology
  • Hypertrophy, Left Ventricular / etiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors