Karanikola AE, Tsiachris D, Argyriou N, Botis M, Pamporis K, Xydis P, Fragoulis C, Kordalis A, Tsioufis K. Complex interrelationship and therapeutic advances in diabetic patients with atrial fibrillation. World J Cardiol 2025; 17(12): 114575 [DOI: 10.4330/wjc.v17.i12.114575]
Corresponding Author of This Article
Dimitrios Tsiachris, Assistant Professor, First Department of Cardiology, National and Kapodistrian University of Athens, “Hippokration” General Hospital, Vas. Sofias 114, Athens 11527, Greece. dtsiachris@yahoo.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
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Review
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 26, 2025 (publication date) through Dec 24, 2025
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Journal Information of This Article
Publication Name
World Journal of Cardiology
ISSN
1949-8462
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Karanikola AE, Tsiachris D, Argyriou N, Botis M, Pamporis K, Xydis P, Fragoulis C, Kordalis A, Tsioufis K. Complex interrelationship and therapeutic advances in diabetic patients with atrial fibrillation. World J Cardiol 2025; 17(12): 114575 [DOI: 10.4330/wjc.v17.i12.114575]
Aikaterini-Eleftheria Karanikola, Dimitrios Tsiachris, Nikos Argyriou, Michail Botis, Konstantinos Pamporis, Panagiotis Xydis, Christos Fragoulis, Athanasios Kordalis, Konstantinos Tsioufis, First Department of Cardiology, National and Kapodistrian University of Athens, “Hippokration” General Hospital, Athens 11527, Greece
Author contributions: Tsiachris D contributed to conceptualization; Karanikola AE, Argyriou N, Botis M, and Pamporis K contributed to literature review; Karanikola AE wrote the original manuscript; Tsiachris D, Xydis P, and Kordalis A contributed to review and editing of the first draft; Tsiachris D and Tsioufis K did supervision. All authors have read and agreed to the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitrios Tsiachris, Assistant Professor, First Department of Cardiology, National and Kapodistrian University of Athens, “Hippokration” General Hospital, Vas. Sofias 114, Athens 11527, Greece. dtsiachris@yahoo.com
Received: September 24, 2025 Revised: October 8, 2025 Accepted: November 10, 2025 Published online: December 26, 2025 Processing time: 91 Days and 14.5 Hours
Abstract
Diabetes mellitus and atrial fibrillation (AF) are two global epidemics that frequently coexist, with diabetes mellitus contributing to both an increased risk of new-onset AF and a worse prognosis. Pathophysiological mechanisms underlying this relationship include chronic inflammation, oxidative stress, atrial remodeling, autonomic dysfunction, advanced glycation end-products and epicardial adiposity. Management remains challenging; however, recent advances offer promise, including guideline-directed anticoagulation, tailored rate and rhythm control, and particularly, novel antidiabetic therapies, such as sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists, may improve AF outcomes. A comprehensive, individualized approach is essential to mitigate morbidity and mortality in this high-risk population.
Core Tip: Diabetes and atrial fibrillation are closely related conditions that increase cardiovascular risk through shared mechanisms of metabolic dysfunction, inflammation and atrial remodeling. Their coexistence complicates treatment decisions, yet novel strategies are reshaping care. Beyond optimized anticoagulation and rhythm control, emerging antidiabetic agents show promise in improving outcomes. This comprehensive review highlights current evidence, evolving therapies and the need for individualized management to reduce the burden of morbidity and mortality in this population.
