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Protective Effects of Sodium-Glucose Transporter 2 Inhibitors on Atrial Fibrillation and Atrial Flutter: A Systematic

Daobo Li1, Yingying Liu1, Tesfaldet Habtemariam Hidru1

  • 1Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.

Frontiers in Endocrinology
|April 5, 2021
PubMed
Abstract

Insights

Sodium-glucose transporter 2 inhibitors (SGLT2i) significantly reduce the risk of atrial fibrillation (AF) and atrial flutter (AFL). Dapagliflozin showed the most significant protective effect among SGLT2i in this meta-analysis.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Hyperglycemia is a known risk factor for developing atrial fibrillation (AF) and atrial flutter (AFL).
  • Existing studies show conflicting results regarding the efficacy of Sodium-glucose transporter 2 inhibitors (SGLT2i) in preventing AF/AFL.
  • A meta-analysis was conducted to clarify the association between SGLT2i use and AF/AFL risk.

Purpose of the Study:

  • To investigate the association between SGLT2i use and the risk of developing AF/AFL.
  • To conduct a meta-analysis of randomized placebo-controlled trials (RCTs).
  • To evaluate the efficacy of different SGLT2i in preventing AF/AFL.

Main Methods:

  • A systematic literature search was performed across PubMed, Scopus, Web of Science, and the Cochrane library.
  • Included randomized placebo-controlled trials comparing SGLT2i with placebo.
  • Data from 33 trials involving 66,685 patients were analyzed.

Main Results:

  • SGLT2i use was associated with a significant reduction in serious adverse events (SAEs) of AF/AFL (0.96% vs. 1.19%, RR 0.83, P=0.01).
  • A significant decrease in AF occurrence SAEs was observed in the SGLT2i group (0.82% vs. 1.06%, RR 0.81, P=0.01).
  • Subgroup analysis revealed that only dapagliflozin significantly reduced AF/AFL incidence (RR 0.73, P=0.002), while other SGLT2i did not show significant effects.

Conclusions:

  • SGLT2i use is linked to a 19.33% lower risk of serious adverse events related to AF/AFL compared to placebo.
  • Dapagliflozin demonstrated the most substantial reduction in AF/AFL incidence among the studied SGLT2i.
  • Further research is warranted to confirm the protective effects of other SGLT2i against AF/AFL.
Keywords:
atrial fibrillationatrial flutterdapagliflozinpreventionsodium-glucose transporter 2 inhibitors

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