The impact of associated diabetic retinopathy on stroke and severe bleeding risk in diabetic patients with atrial fibrillation: The Loire Valley Atrial Fibrillation Project.

ConclusionCrude rates of stroke/TE increased in a stepwise fashion when non-diabetic AF patients were compared to diabetics with no retinopathy and diabetics with retinopathy. However, we have shown for the first time that the presence of diabetic retinopathy did not emerge as an independent predictor for stroke/TE or severe bleeding on multivariate analysis. Background: Diabetes mellitus is recognized as a stroke risk factor in atrial fibrillation (AF). Diabetics with retinopathy have an increased risk of systemic cardiovascular complications, and also, severe diabetic retinopathy predisposes to ocular bleeds. We hypothesised that diabetic AF patients with retinopathy have increased stroke/thromboembolism and severe bleeding risks in AF, when compared to diabetic AF patients without retinopathy, or to non-diabetics with AF. Methods and Results: We tested our hypothesis in a large "real- world" cohort of individuals with AF from the Loire Valley Atrial Fibrillation project. Of 8962 patients with AF on our dataset, 1409 (16%) had documented diabetes mellitus, of which, 163 (1.8% of the whole cohort) were patients with diabetic retinopathy. After a followup of 31±36 months, when compared to non-diabetics, the risk of stroke/TE in diabetics with no retinopathy increased 1.3 fold (RR 1.30; 95%CI 1.07-1.59, p=0.01), and in diabetics with retinopathy, the risk of stroke/TE was increased 1.58 fold (RR 1.58; 95%CI 1.07-2.32, p=0.02). There was no significant differen...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research