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Pharmacotherapy for diabetes and stroke risk: Results from ROCKET AF.

Publication ,  Journal Article
Ugowe, FE; Hellkamp, AS; Wang, A; Becker, RC; Berkowitz, SD; Breithardt, G; Fox, KAA; Halperin, JL; Hankey, GJ; Mahaffey, KW; Nessel, CC ...
Published in: Heart Rhythm O2
June 2021

BACKGROUND: Insulin use may be a better predictor of stroke risk and morbidity and mortality than diabetes in patients with atrial fibrillation (AF). OBJECTIVES: Determine if the increased risk of stroke observed in patients with AF and diabetes is restricted to those treated with insulin. METHODS: We analyzed the association between diabetes and treatment and the occurrence of stroke/systemic embolism, myocardial infarction (MI), all-cause death, vascular death, composite outcomes, and bleeding risk in the ROCKET AF trial. RESULTS: In a cohort of 14,264 patients, there were 40.3% (n = 5746) with diabetes, 5.9% (n = 842) on insulin, 18.9% (n = 2697) on oral medications, and 11.9% (n = 1703) diet-controlled. Compared to those without diabetes, patients with non-insulin-treated diabetes had increased risks of stroke (hazard ratio [HR] 1.33, 95% confidence interval [CI] 1.06-1.68), MI (HR 1.64, 95% CI 1.17-2.30), all-cause death (HR 1.26, 95% CI 1.08-1.46), vascular death (HR 1.33, 95% CI 1.11-1.60), and composite outcomes (HR 1.37, 95% CI 1.18-1.157). Patients with insulin-treated diabetes had a significantly higher risk of MI (HR 2.31, 95% CI 1.33-4.01) and composite outcomes (HR 1.57, 95% CI 1.19-2.08) compared to those without diabetes. There were no significant differences between insulin-treated and non-insulin-treated diabetes for any outcome. CONCLUSION: Among patients with AF and diabetes, there were no significant differences in outcomes in insulin-treated diabetes compared to non-insulin-treated diabetes.

Duke Scholars

Published In

Heart Rhythm O2

DOI

EISSN

2666-5018

Publication Date

June 2021

Volume

2

Issue

3

Start / End Page

215 / 222

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ugowe, F. E., Hellkamp, A. S., Wang, A., Becker, R. C., Berkowitz, S. D., Breithardt, G., … of the ROCKET AF Steering Committee and Investigators, . (2021). Pharmacotherapy for diabetes and stroke risk: Results from ROCKET AF. Heart Rhythm O2, 2(3), 215–222. https://doi.org/10.1016/j.hroo.2021.04.001
Ugowe, Francis E., Anne S. Hellkamp, Allen Wang, Richard C. Becker, Scott D. Berkowitz, Günter Breithardt, Keith A. A. Fox, et al. “Pharmacotherapy for diabetes and stroke risk: Results from ROCKET AF.Heart Rhythm O2 2, no. 3 (June 2021): 215–22. https://doi.org/10.1016/j.hroo.2021.04.001.
Ugowe FE, Hellkamp AS, Wang A, Becker RC, Berkowitz SD, Breithardt G, et al. Pharmacotherapy for diabetes and stroke risk: Results from ROCKET AF. Heart Rhythm O2. 2021 Jun;2(3):215–22.
Ugowe, Francis E., et al. “Pharmacotherapy for diabetes and stroke risk: Results from ROCKET AF.Heart Rhythm O2, vol. 2, no. 3, June 2021, pp. 215–22. Pubmed, doi:10.1016/j.hroo.2021.04.001.
Ugowe FE, Hellkamp AS, Wang A, Becker RC, Berkowitz SD, Breithardt G, Fox KAA, Halperin JL, Hankey GJ, Mahaffey KW, Nessel CC, Singer DE, Patel MR, Piccini JP, of the ROCKET AF Steering Committee and Investigators. Pharmacotherapy for diabetes and stroke risk: Results from ROCKET AF. Heart Rhythm O2. 2021 Jun;2(3):215–222.

Published In

Heart Rhythm O2

DOI

EISSN

2666-5018

Publication Date

June 2021

Volume

2

Issue

3

Start / End Page

215 / 222

Location

United States