Effects of Sodium/Glucose Cotransporter Inhibitors on Atrial Fibrillation and Stroke: A Meta-Analysis.

Autor: Ong HT; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Teo YH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Teo YN; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Syn NL; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Wee CF; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Leong S; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Yip ASY; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., See RM; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Ting AZH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Chia AZ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Cheong AJY; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Tan BY; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, University Medicine Cluster, National University Health System, Singapore., Ho JS; Academic Foundation Programme, North Middlesex University Hospital NHS Trust, United Kingdom., Yeo LL; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, University Medicine Cluster, National University Health System, Singapore., Leow AS; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Yeo TC; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, 119228, Singapore., Wong RC; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, 119228, Singapore., Chai P; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, 119228, Singapore., Kojodjojo P; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, 119228, Singapore., Sia CH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, 119228, Singapore. Electronic address: ching_hui_sia@nuhs.edu.sg.
Jazyk: angličtina
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2022 Jan; Vol. 31 (1), pp. 106159. Date of Electronic Publication: 2021 Oct 22.
DOI: 10.1016/j.jstrokecerebrovasdis.2021.106159
Abstrakt: Objectives: Recent clinical trials have shown the potential of sodium glucose cotransporter (SGLT) 2 inhibitors to reduce the risk of atrial fibrillation but not stroke. We conducted a systematic review and meta-analysis to clarify if SGLT2 or combined SGLT1/2 inhibitors affect the risk of atrial fibrillation and stroke in patients regardless of diabetic status.
Materials and Methods: Four electronic databases were searched on 21st November 2020 for studies evaluating outcomes of stroke and atrial fibrillation with SGLT2 or combined SGLT1/2 inhibitors in both diabetic and non-diabetic patients. Both random and fixed effect, pair-wise meta-analysis models were used to summarize the results of the studies.
Results: A total of 13 placebo-controlled, randomized-controlled trials were included. Eight trials comprising 35,702 patients were included in the analysis of atrial fibrillation outcomes and eight trials comprising 47,910 patients were included in the analysis of stroke outcomes. Patients on SGLT inhibitors, particularly SGLT2 inhibitors, had lower odds of atrial fibrillation (Peto odds ratio [95% confidence interval] = 0.76 [0.63-0.92]) compared to placebo. This effect remained significant with a follow-up duration longer than 1 year, in studies utilizing dapagliflozin, patients with type 2 diabetes mellitus, and patients with cardiovascular disease. No difference was observed in the odds of atrial fibrillation in patients with baseline heart failure. No effect was seen on the risk of stroke in patients taking SGLT inhibitors.
Conclusions: SGLT2 inhibitors significantly reduced the odds of atrial fibrillation in diabetic patients. However, SGLT inhibitors did not significantly affect the risk of stroke.
Competing Interests: Declaration of Competing Interest None
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: