Introduction: It is known that women with diabetes mellitus (DM) have a higher risk to develop atrial fibrillation (AF) compared to men with DM. However, it is unknown whether gender risk differences exist across various racial/ethnic groups.
Hypothesis: There exists a relationship between DM and race/ethnicity for the risk to develop AF.
Methods: We retrospectively followed 32,250 persons free of AF (46% Hispanic, 39% African American and 15% non-Hispanic White, mean age 60 years) for subsequent incident AF (ascertained by electrocardiograms). DM was analyzed as a categorical variable (DM as HbA1c >=6.5). Cox regression analysis controlled for baseline covariates: DM, gender, race/ethnicity, heart failure, age, treatment for hypertension, body mass index, systolic blood pressure and social economic status. Regression analysis was performed for the entire cohort and then stratified by gender and racial/ethnic group. P-value <0.05 was deemed statistically significant.
Results: Over a follow-up of 13 years, 3,395 AF cases occurred (mean age 70, 45% male). There was a significant difference between the incidence of DM by race (42% Hispanic, 41% African American and 33% non-Hispanic White). When stratified by gender, the presence of DM in women was predictive of AF (HR = 1.11, 95% CI 1.01-1.22, p-value =0.03), but was not statistically significant in men. When further stratified by race/ethnicity, the presence of DM in Hispanic women was predictive of AF (HR = 1.19, 95% CI: 1.03-1.39, p=0.02), but was not significant in either gender in non-Hispanic Whites or Hispanics (Table 1).
Conclusions: There is a clear difference in the incidence of DM and risk to develop AF by gender and race. Our study suggests that women with DM have a significantly higher risk to develop AF than men with DM, and this is particularly true for Hispanic women.