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    Risk of developing diabetes in patients with atrial fibrillation taking non-vitamin K antagonist oral anticoagulants or warfarin: A nationwide cohort study

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    Author
    Huang, Huei-Kai
    Liu, Peter Pin-Sung
    Lin, Shu-Man
    Hsu, Jin-Yi
    Peng, Carol Chiung-Hui
    Munir, Kashif M
    Wu, Ting-Yu
    Yeh, Jih-I
    Loh, Ching-Hui
    Tu, Yu-Kang
    Date
    2020-11-02
    Journal
    Diabetes, Obesity & Metabolism
    Publisher
    Blackwell Publishing
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1111/dom.14243
    Abstract
    Aim: To compare the risk of diabetes development in patients with atrial fibrillation (AF) treated with non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin. Materials and Methods: We conducted a nationwide retrospective cohort study using Taiwan's National Health Insurance Research Database. Adult patients with new onset of AF, treated with NOACs or warfarin between 2012 and 2016, were included. The NOAC cohort was further divided into dabigatran, rivaroxaban and apixaban groups. The primary outcome was incident diabetes requiring treatment with antidiabetic drugs. Fine and Gray subdistribution hazards models were used to estimate the adjusted hazard ratio (aHR). Propensity score matching was performed for each head-to-head comparison. Results: A total of 10 746 new-onset AF patients were included in our study. During the mean 2.4-year follow-up, NOACs were associated with a lower risk of developing diabetes than warfarin (aHR = 0.80, 95% confidence interval [CI]: 0.68-0.94, P =.007). Subgroup analyses confirmed that dabigatran, rivaroxaban and apixaban each had a reduced diabetes risk. Stratified analyses showed that the lower risk of diabetes associated with NOAC treatment was specific to patients aged 65 years or older (aHR = 0.74, 95% CI: 0.62-0.89, P =.002) and those with good medication adherence (aHR = 0.70, 95% CI: 0.58-0.84, P <.001). Conclusions: Taking an NOAC was associated with a lower risk of developing diabetes than taking warfarin in patients with AF.
    Rights/Terms
    © 2020 John Wiley & Sons Ltd.
    Keyword
    atrial fibrillation
    diabetes
    NOAC
    oral anticoagulant
    warfarin
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/14189
    ae974a485f413a2113503eed53cd6c53
    10.1111/dom.14243
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