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Cardiovascular Diabetology

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Open Access 01-12-2023 | Dapagliflozin | Review

Sodium-glucose cotransporter 2 inhibitor may not prevent atrial fibrillation in patients with heart failure: a systematic review

Authors: Xiaolan Ouyang, Jiafu Wang, Qian Chen, Long Peng, Suhua Li, Xixiang Tang

Published in: Cardiovascular Diabetology | Issue 1/2023

Abstract

Background

Atrial fibrillation (AF) and heart failure (HF) frequently coexist because of their similar pathological basis. However, whether sodium-glucose cotransporter 2 inhibitor (SGLT2i), a novel class of anti-HF medication, decreases the risk of AF in HF patients remains unclear.

Objectives

The aim of this study was to assess the relationship between SGLT2i and AF in HF patients.

Methods

A meta-analysis of randomized controlled trails evaluating the effects of SGLT2i on AF in HF patients was performed. PubMed and ClinicalTrails.gov were searched for eligible studies until 27 November 2022. The risk of bias and quality of evidence were assessed through the Cochrane tool. Pooled risk ratio of AF for SGLT2i versus placebo in eligible studies was calculated.

Results

A total of 10 eligible RCTs examining 16,579 patients were included in the analysis. AF events occurred in 4.20% (348/8292) patients treated with SGLT2i, and in 4.57% (379/8287) patients treated with placebo. Meta-analysis showed that SGLT2i did not significantly reduce the risk of AF (RR 0.92; 95% CI 0.80–1.06; p = 0.23) in HF patients when compared to placebo. Similar results remained in the subgroup analyses, regardless of the type of SGLT2i, the type of HF, and the duration of follow-up.

Conclusions

Current evidences showed that SGLT2i may have no preventive effects on the risk of AF in patients with HF.

Translational perspective

Despite HF being one of the most common heart diseases and conferring increased risk for AF, affective prevention of AF in HF patients is still unresolved. The present meta-analysis demonstrated that SGLT2i may have no preventive effects on reducing AF in patients with HF. How to effectively prevent and early detect the occurrence of AF is worth discussing.

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Title: Sodium-glucose cotransporter 2 inhibitor may not prevent atrial fibrillation in patients with heart failure: a systematic review
Authors: Xiaolan Ouyang
Jiafu Wang
Qian Chen
Long Peng
Suhua Li
Xixiang Tang
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Dapagliflozin
Empagliflozin
Heart Failure
Atrial Fibrillation
Published in: Cardiovascular Diabetology / Issue 1/2023
Electronic ISSN: 1475-2840
DOI: https://doi.org/10.1186/s12933-023-01860-1

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Abstract

Background

Objectives

Methods

Results

Conclusions

Translational perspective

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