Cardiovasc Diabetol: Risk of atrial fibrillation in patients with type 2 diabetes treated with SGLT2i, GLP1RA and DPP-4 inhibitors

Background: Type 2 diabetes and atrial fibrillation are common chronic clinical disease burdens and ageing populations worldwid.

A recent meta-analysis comparing the risk of atrial fibrillation (AF) among users of SGLT2i, GLP1RA, and placebo (DPP4i and other antidiabetic drugs) has conflicting result.

Objectives: We therefore aimed to investigate the risk of new-onset atrial fibrillation among DPP4i, GLP-1RA and SGLT2i users, using a direct head-to-head comparison, in a large real-world context, with a particular focus on those with type 2 diabetes Asian crow.

Methods: In this nationwide retrospective cohort study based on the Taiwan National Health Insurance Research Database, from May 1, 2016 to December 31, 2019, a total of 344, 893, 44, 370 and 393, 100 consecutive of T2DM patients without AF were treated with GLP-1RA, SGLT2i and DPP4i, respectivel.

Results: After PSM, sgl t2i-DPP4i, sgl t2i-GLP-1RA and GLP-1RA-DPP4i had 245, 442, 43, 682 and 39,190 paired cohorts, respectivel.

Figure 1 Cumulative risk of atrial fibrillation events for SGTL2i and DPP4i (A), Sgt L2 I and GLP 1RA (B), and GLP 1RA and DPP4i (C) paired study cohorts after PSM treatmen.

Figure 2 Sensitivity analysis of hazard ratios for atrial fibrillation events in paired study cohorts treated with SGTL2i versus DPP4i, Sgt L2 I versus GLP 1RA, and GLP 1RA versus DPP4i after PS.

Conclusions: Compared with DPP4i, SGLT2i, but not GLP 1RA, was associated with a lower risk of developing atrial fibrillation in patients with type 2 diabete.

Original source: Chan YH, Chao TF, Chen SW, et a.