Role of CHA2DS2-VASc score in predicting new-onset atrial fibrillation in patients with type 2 diabetes mellitus with and without hyperosmolar hyperglycaemic state: real-world data from a nationwide cohort

Purpose The objective of the current study was to explore the role of CHA(2)DS(2)-VASc score in predicting incidence of atrial fibrillation (AF) in patients with type 2 diabetes mellitus (DM). Furthermore, the use of the CHA(2)DS(2)-VASc score for stratifying new-onset AF risk in patients with DM and with/without hyperosmolar hyperglycaemic state (HHS) was also compared. Methods The study subjects were identified from Longitudinal Health Insurance Database provided by the National Health Research Institutes. The patients with DM were divided into two groups based on a history of HHS or not. The predictive ability of CHA2DS2-VASc score for stratifying new-onset AF risk in the two groups was calculated using the area under the curve of receiver operating characteristic (AUROC). Results The present study involved a total of 69 530 patients with type 2 DM. Among them, 1558 patients had a history of HHS, whereas 67972 patients did not. The AUROC of the CHA(2)DS(2)-VASc score as a predictor of incident AF in patients with DM and with/without HHS was 0.67 (95% CI 0.59 to 0.75) and 0.71 (95% CI 0.70 to 0.72), respectively. Conclusions To conclude, we reported for the first time on the assessment of CHA(2)DS(2)-VASc score for incident AF risk discrimination in patients with type 2 DM. We further found that the predictive ability of the CHA(2)DS(2)-VASc score was attenuated in patients with type 2 DM and with HHS in comparison with those without HHS.