Considerations and treatment options for patients with comorbid atrial fibrillation and diabetes mellitus

Expert Opin Pharmacother. 2017 Aug;18(11):1101-1114. doi: 10.1080/14656566.2017.1350647. Epub 2017 Jul 10.

Abstract

Atrial fibrillation (AF) and diabetes mellitus (DM) are common worldwide and their incidence is increasing, representing a significant public health and economic burden as well as an increase in individual increased morbidity and mortality risk profiles. Both conditions are closely related, as patients with DM are at increased risk of incident AF, and AF patients with DM are at higher risk of cardiovascular events compared to non-AF patients. Areas covered: This review article aims to provide an overview of the current evidence linking DM and AF, as well as the impact of obesity, weight loss and stroke on these coexisting conditions. Second, the effects of new oral anti hyperglycaemic medications on cardiovascular risk will be considered. Expert opinion: In conclusion, coexisting AF and DM represent a high risk population of patients requiring aggressive risk factor identification and treatment optimisation. The multifactorial interplay between these conditions requires individual assessment of patient risk profiles with the aim of minimising the impact of each modifiable risk factor.

Keywords: Anticoagulation; atrial fibrillation; diabetes; empagliflozin; obesity; stroke.

Publication types

  • Review

MeSH terms

  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use*
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / etiology
  • Comorbidity
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / therapeutic use*
  • Hypolipidemic Agents / administration & dosage
  • Hypolipidemic Agents / therapeutic use*
  • Incidence
  • Obesity / complications
  • Obesity / drug therapy
  • Obesity / epidemiology
  • Risk Assessment
  • Risk Factors
  • Stroke / epidemiology
  • Stroke / etiology
  • Stroke / prevention & control
  • Weight Loss

Substances

  • Anticoagulants
  • Hypoglycemic Agents
  • Hypolipidemic Agents