Lower Atrial Fibrillation Risk With Sodium-Glucose Cotransporter 2Inhibitors Than With Dipeptidyl Peptidase-4 Inhibitors in Individuals With Type 2 Diabetes: A Nationwide Cohort Study
- Author:
Min KIM
1
;
Kyoung Hwa HA
;
Junyoung LEE
;
Sangshin PARK
;
Kyeong Seok OH
;
Dae-Hwan BAE
;
Ju Hee LEE
;
Sang Min KIM
;
Woong Gil CHOI
;
Kyung-Kuk HWANG
;
Dong-Woon KIM
;
Myeong-Chan CHO
;
Dae Jung KIM
;
Jang-Whan BAE
Author Information
- Publication Type:Original Research
- From:Korean Circulation Journal 2024;54(5):256-267
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Background and Objectives:Accumulating evidence shows that sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce adverse cardiovascular outcomes. However, whether SGLT2i, compared with other antidiabetic drugs, reduce the new development of atrial fibrillation (AF) is unclear. In this study, we compared SGLT2i with dipeptidyl peptidase-4 inhibitors (DPP-4is) in terms of reduction in the risk of AF in individuals with type 2 diabetes.
Methods:We included 42,786 propensity score-matched pairs of SGLT2i and DPP-4i users without previous AF diagnosis using the Korean National Health Insurance Service database between May 1, 2016, and December 31, 2018.
Results:During a median follow-up of 1.3 years, SGLT2i users had a lower incidence of AF than DPP-4i users (1.95 vs. 2.65 per 1,000 person-years; hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55–0.97; p=0.028]). In individuals without heart failure, SGLT2i users was associated with a decreased risk of AF incidence (HR, 0.70; 95% CI, 0.52–0.94; p=0.019) compared to DPP-4i users. However, individuals with heart failure, SGLT2i users was not significantly associated with a change in risk (HR, 1.04; 95% CI, 0.44–2.44; p=0.936).
Conclusions:In this nationwide cohort study of individuals with type 2 diabetes, treatment with SGLT2i was associated with a lower risk of AF compared with treatment with DPP-4i.
