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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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SGLT2i effect on atrial fibrillation: A network meta-analysis of randomized controlled trials

Marco Valerio Mariani1, Giovanna Manzi1, Nicola Pierucci1

  • 1Department of Cardiovascular, Respiratory, Nephrological, Aenesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy.

Journal of Cardiovascular Electrophysiology
|June 28, 2024
PubMed

Insights

Gliflozins reduce atrial fibrillation (AF) occurrence, with dapagliflozin showing significant risk reduction compared to placebo in overall and diabetic populations. Other gliflozins did not show significant AF reduction benefits.

Area of Science:

  • Cardiology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Gliflozins are recommended for heart failure and cardiovascular comorbidities, showing reduced atrial fibrillation (AF) occurrence.
  • The comparative cardioprotective effects of different gliflozins regarding AF reduction are not well-established.

Purpose of the Study:

  • To compare the efficacy of different gliflozins in reducing AF occurrence.
  • To analyze AF recurrence data associated with various gliflozin medications.

Main Methods:

  • A meta-analysis of 59 studies was conducted, including 108,026 patients (60,097 on gliflozins, 47,929 on placebo).
  • Data were searched from online scientific libraries up to June 1, 2023.

Main Results:

  • Gliflozins significantly reduced AF occurrence versus standard care (RR: 0.8880, p=.0164) and in patients with diabetes and cardiorenal diseases (RR: 0.8352, p=.0155).
  • Dapagliflozin significantly decreased AF occurrence versus placebo in the overall population (RR: 0.7259, p<.0001), in diabetic patients (RR: 0.2482, p=.0345), and those with diabetes and cardiorenal diseases (RR: 0.7192, p=.0063).
  • No significant differences in AF protection were observed among different gliflozins.

Conclusions:

  • Dapagliflozin use is linked to a significant reduction in AF risk compared to placebo, particularly in the overall and diabetic patient groups.
  • The study highlights dapagliflozin's specific benefit in reducing AF occurrence, while other gliflozins did not demonstrate significant reductions.
Abstract

Keywords:
RCTsSGLT2iatrial fibrillationnetwork meta‐analysis

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