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-  2015 

Atrial fibrillation in patients with diabetes: molecular mechanisms and therapeutic perspectives

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Abstract:

AF management represents a daily challenge for physicians in terms of controlling disabling symptoms and protecting from thromboembolism. AF is associated with multiple complications including heart failure and stroke. It is also related with a significant increase in mortality (1). The prevalence of AF is markedly related with advanced age. Due to a significant increase in overall survival AF prevalence is becoming dramatically high and it is nowadays the most prevalent cardiac sustained arrhythmia (2). Consensually the number of people with DM is alarmingly increasing worldwide due to the growing prevalence of lifestyle changes leading to obesity, or genetic susceptibility (3). Moreover, the number of affected people is expected to rise further if we consider ageing. AF is one of the main cardiovascular complications associated with diabetic disease. Data from the Framingham Heart Study showed that in addition to intrinsic cardiac causes such as valve disease and congestive heart failure, risk factors for cardiovascular disease also predispose to AF. Between these, DM conferred an odds ratio of 1.4 for men and 1.6 for women, after multivariable adjustment, for developing AF (4). The incidence of AF in patients with DM is reported to be 14.9%, and in the same study atrial flutter occurred in 4% of DM patients vs. 2.5% of the control group (P<0.0001) (5). Furthermore DM is cohesive to metabolic syndrome, including obesity which is an established risk factor for AF (6)

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