title: Diabetes mellitus is a strong, independent risk for atrial fibrillation and flutter in addition to other cardiovascular disease.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a major risk factor for atherosclerosis. There is a controversy in literature about correlation between DM and atrial fibrillation. The goal of this study was to evaluate DM as a risk factor for atrial fibrillation or flutter using a very large database.
  
  
  METHODS
  Patient treatment files (PTF) containing discharge diagnoses were utilized using ICD-9 codes of inpatient treatment from Veterans Health Administration Hospitals (VAH). Patients with type II DM (ICD-9 code 250.0) (293,124) discharged from the VAH between 1990 and 2000. Non-matched controls without DM but with hypertension (552,624) were selected from the same PTF. By using multi-variate logistic regressions, the occurrence of atrial fibrillation, atrial flutter, CHF, CAD and LVH was compared.
  
  
  RESULTS
  Atrial fibrillations occurred in 43,674 (14.9%) DM patients vs. 57,077 (10.3%) in the control group (p<0.0001). Atrial flutter occurred in 11,852 (4%) of DM patients vs. 13,554 (2.5%) of the control group (p<0.0001). Using multi-variant analysis, DM remained independently associated with atrial fibrillation with an OR of 2.13, (95% CI: 2.10 to 2.16; p<0.0001) and flutter (OR 2.20, CI: 2.15 to 2.26; p<0.0001). Furthermore, CHF (OR 3.12, CI: 3.09 to 3.16; p<0.0001), LVH (OR 1.85, CI: 1.77 to 1.92; p<0.0001) and CAD (OR 2.39, CI: 2.34 to 2.44; p<0.0001) were also independently associated with DM.
  
  
  CONCLUSIONS
  This is the first large-scale study finding DM as a strong, independent risk for the occurrence of atrial fibrillation and flutter and other cardiovascular disease.
authors.affiliation: Division of Cardiology, University of California, Irvine, Medical Center Department of Medicine, 101 The City Drive, Bldg. 53, Rm 100, Orange, CA 92868, United States. rmova@aol.com
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Movahed
authors.forename: Mehrtash
authors.initials: M
authors.lastname: Hashemzadeh
authors.forename: M Mazen
authors.initials: MM
authors.lastname: Jamal
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology; D001282:Atrial Flutter / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology; D048909:Diabetes Complications / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors