Proteinuria and the risk of Incident atrial fibrillation according to glycemic stages: a nationwide population-based cohort study
Authors' conclusion
Proteinuria is an independent and significant risk factor for incident AF at all glycemic stages. The risk of incident AF in patients with DM can be stratified by measuring the level of proteinuria rather than comparing the duration of DM. Tailoring clinical strategies to proteinuria level could potentially mitigate this risk, improving patient outcomes.
Study context
- Population
- Individuals without prior atrial fibrillation (AF) and T1D, 2009 Korean National Health Insurance Service health checkup; mean age 47 ± 14 years, 44.8% female
- Participants
- 4,044,524 individuals
- Exposure
- Proteinuria levels across glycemic stages
- Outcome
- Incident AF
- Follow-up
- Tracked until 2023
Main finding
As reported in the abstract
Incident AF with urine dipstick 3+/4+ proteinuria, by glycemic stage
| Group | aHR for urine dipstick 3+/4+ |
|---|---|
| Normal | 1.58 |
| Prediabetes | 1.64 |
| New-onset diabetes mellitus (DM) | 2.39 |
| Early DM | 2.12 |
| Late DM | 2.53 |
aHR for urine dipstick 3+/4+
Normal1.58
Prediabetes1.64
New-onset diabetes mellitus (DM)2.39
Early DM2.12
Late DM2.53
Observational data: associations, not effects.
Further findings
Per 1000 person-years
| Outcome | Normal | Late DM | P value |
|---|---|---|---|
| Annual AF incidence by glycemic stageIncreasing from normal to late DM | 2.05 | 7.22 | P < 0.001 |
AF incidence by proteinuria level
- Incidence rates increased with increasing proteinuria, from 2.46 to 8.18 per 1000 person-years (p < 0.001)
Original publication
Proteinuria and the risk of Incident atrial fibrillation according to glycemic stages: a nationwide population-based cohort study. Cardiovasc Diabetol. Published 24 January 2025. doi:10.
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