Related Experiment Video

Updated: May 26, 2025

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

83.4K

SGLT2i and Cardiovascular Events in Patients With Concomitant Atrial Fibrillation and Diabetes: A TriNetX Cohort

Yu-Yu Hsiao1, Yun-Yu Chen1,2,3,4,5, Ming-Jen Kuo1,2,5,6

  • 1Cardiovascular Center, Taichung Veterans General Hospital, Taichung 407219, Taiwan.

The Journal of Clinical Endocrinology and Metabolism
|February 25, 2025
PubMed
Abstract

Insights

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) reduce cardiovascular risks in patients with type 2 diabetes mellitus and atrial fibrillation. This study found SGLT2i use significantly lowered stroke, dementia, heart failure, and mortality risks.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are established cardiovascular risk reducers in type 2 diabetes mellitus (T2DM).
  • The impact of SGLT2i on cardiovascular outcomes in T2DM patients with concomitant atrial fibrillation (AF) is not well-defined.

Purpose of the Study:

  • To investigate the effect of SGLT2 inhibitors on cardiovascular outcomes in patients diagnosed with both atrial fibrillation and type 2 diabetes mellitus.

Main Methods:

  • A large cohort of patients with AF and T2DM was identified from an international electronic medical record database.
  • Propensity score matching (PSM) was employed to create two comparable groups: SGLT2 inhibitor users and non-users (1:1 ratio).
  • Multivariate Cox hazards regression analysis was used to determine hazard ratios for clinical outcomes over a 3-year follow-up period.

Main Results:

  • The study included 339,792 patients with AF and T2DM; 32,945 (9.70%) used SGLT2i.
  • Post-PSM, 17,011 patients were analyzed in each group, with a mean age of 68.4 ± 7.9 years.
  • SGLT2i users exhibited significantly lower risks of stroke (aHR: 0.830), dementia (aHR: 0.662), long-standing persistent AF (aHR: 0.917), heart failure (aHR: 0.833), and all-cause mortality (aHR: 0.532).

Conclusions:

  • SGLT2 inhibitor use is associated with significant reductions in stroke, dementia, persistent AF, heart failure, and mortality in patients with both AF and T2DM.
  • These findings suggest SGLT2 inhibitors may be a valuable therapeutic option, potentially as a first-line treatment, for this patient population.
Keywords:
SGLT2 inhibitoratrial fibrillationdementiaheart failurestroketype 2 diabetes

More Related Videos

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.2K
Experimental and Imaging Techniques for Examining Fibrin Clot Structures in Normal and Diseased States07:09

Experimental and Imaging Techniques for Examining Fibrin Clot Structures in Normal and Diseased States

Published on: April 1, 2015

11.4K

Related Concept Videos

Glucose Transporters01:27

Glucose Transporters

Glucose transporters facilitate the transport of glucose across the cell membrane. In addition to glucose, some glucose transporters can also aid the movement of other hexoses such as fructose, mannose, and galactose.
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
22.4K
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
162
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
131
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
152
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.2K
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.1K