ArticleCardiovascular diabetology2022
Impact of mental disorders on the risk of atrial fibrillation in patients with diabetes mellitus: a nationwide population-based study.
Article in Cardiovascular diabetology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Depression and anxiety disorders in patients with atrial fibrillation undergoing a pulmonary vein isolation: A systematic literature review and meta-analysis.Scientific reports · 2026Pooled it
- The Anxiety-AFib connection: a systematic review of mental health and arrhythmia interactions.Global cardiology science & practice · 2026Review
- Sleep Disruption and Atrial Fibrillation: Evidence, Mechanisms and Clinical Implications.Circulation research · 2025Review
- Debating the link between atrial fibrillation and psychiatric diseases through CaWorld journal of psychiatry · 2025Review
- The Role of Early Risk Factor Modification and Ablation in Atrial Fibrillation Substrate Remodeling Prevention.Biomedicines · 2025Review
- Neuroticism and the Risk of Atrial Fibrillation: An Observational Epidemiologic and Mendelian Randomization Study.JACC. Asia · 2024Article
- Atrial fibrillation: comorbidities, lifestyle, and patient factors.The Lancet regional health. Europe · 2024Review
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Authors and funding
10 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundIt is unclear whether mental disorders are an independent risk factor for atrial fibrillation (AF) in patients with diabetes. We aimed to investigate whether patients with diabetes who have mental disorders have an increased risk for AF.
methodsUsing the Korea National Health Insurance Service database, we enrolled 2,512,690 patients diagnosed with diabetes without AF between 2009 and 2012. We assessed five mental disorders: depression, insomnia, anxiety, bipolar disorder, and schizophrenia. Newly diagnosed AF was identified during the follow-up period, and multivariate Cox regression analysis was performed.
resultsAmong the 2,512,690 patients (mean age 57.2 ± 12.3 years; 60.1% men), 828,929 (33.0%) had mental disorders. Among the five mental disorders, anxiety (68.1%) was the most common, followed by insomnia (40.0%). During a median follow-up duration of 7.1 years, new-onset AF was diagnosed in 79,525 patients (4.66 per 1,000 person-years). Patients with diabetes who had mental disorders showed a higher risk for AF (adjusted hazard ratio [HR] 1.19; 95% confidence interval [CI] 1.17-1.21; p-value < 0.001). Depression, insomnia, and anxiety were significantly associated with higher risk for AF (adjusted HR [95% CI]: 1.15 [1.12-1.17], 1.15 [1.13-1.18], and 1.19 [1.67-1.21], respectively; all p-values < 0.001), whereas bipolar disorder and schizophrenia were not.
conclusionsMental disorders, especially depression, insomnia, and anxiety, were associated with an increased risk for AF in patients with diabetes. Greater awareness with a prompt diagnosis of AF should be considered for patients with both DM and mental disorders.
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