Impact of SGLT2 Inhibitors on Atrial Fibrillation Recurrence after Catheter Ablation in Type 2 Diabetes Mellitus: A Meta-Analysis of Reconstructed Kaplan-Meier Curves with Trial Sequential Analysis.

Autor: Soliman Y; Faculty of Medicine, Assiut University, Assiut, Egypt. Youssefrefaat138@gmail.com., Abuelazm M; Faculty of Medicine, Tanta University, Tanta, Egypt., Amer BE; Medical Research Group of Egypt, Cairo, Egypt.; Faculty of Medicine, Benha University, Benha, Egypt., Hukamdad M; University of Illinois College of Medicine, Chicago, IL, USA., Ellabban MH; Medical Research Group of Egypt, Cairo, Egypt.; Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Hendi NI; Medical Research Group of Egypt, Cairo, Egypt.; Faculty of Medicine, Ain Shams University, Cairo, Egypt., Mouffokes A; Medical Research Group of Egypt, Cairo, Egypt.; Faculty of Medicine, University of Oran 1 Ahmed Ben Bella, Oran, Algeria., AbdelAzeem B; Department of Cardiology, West Virginia University, Morgantown, WV, USA., Hassaballa H; Division of Cardiovascular Medicine, The University of Chicago Medicine, Chicago, IL, USA.
Jazyk: angličtina
Zdroj: American journal of cardiovascular drugs : drugs, devices, and other interventions [Am J Cardiovasc Drugs] 2024 Sep; Vol. 24 (5), pp. 629-640. Date of Electronic Publication: 2024 Jul 04.
DOI: 10.1007/s40256-024-00661-5
Abstrakt: Purpose: The role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in managing cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM) is evolving. This meta-analysis seeks to explore the influence of SGLT2i on the recurrence of atrial fibrillation (AF) following catheter ablation (CA) in individuals with T2DM qualitatively and quantitatively.
Methods: A comprehensive literature search was conducted in electronic databases. Studies meeting predefined criteria were included. Individual patient data (IPD) were used from reconstructed time-to-event data to estimate hazard ratios (HRs) and 95% confidence intervals for AF recurrence. IPD meta-analysis was followed by a direct meta-analysis to assess the risk of AF recurrence.
Results: A total of five studies [one randomized controlled trial (RCT) and four cohort studies] were included in this study, and five studies were included in the qualitative analysis, while four studies comprising 1043 patients with T2DM were included in the quantitative analysis. The pooled Kaplan-Meier curve based on reconstructed data showed a significantly lower risk of AF recurrence in the SGLT2i group compared with all antidiabetic drugs (log-rank P = 0.00011) and dipeptidyl-peptidase IV inhibitors (DPP4i) (log-rank P = 0.01). Cox regression analysis showed consistent results. Direct meta-analysis showed that SGLT2i, compared with all antidiabetic medications (HR 0.57, 95% CI [0.44, 0.73], I 2 ) and DPP4i (HR 0.41, 95% CI [0.24, 0.70], I 2 ), was associated with a lower risk of AF recurrence.
Conclusions: SGLT2i are associated with a reduced risk of AF recurrence after CA in patients with T2DM. These results suggest that SGLT2i is promising in improving clinical outcomes for this population.
(© 2024. The Author(s).)
Databáze: MEDLINE
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