Association between sodium-glucose cotransporter-2 inhibitors and incident atrial fibrillation/atrial flutter in heart failure patients with reduced ejection fraction: a meta-analysis of randomized controlled trials

Autor: Dimitrios Sfairopoulos, Tong Liu, Nan Zhang, Gary Tse, George Bazoukis, Konstantinos Letsas, Christos Goudis, Haralampos Milionis, Apostolos Vrettos, Panagiotis Korantzopoulos
Rok vydání: 2022
Předmět:
Zdroj: Heart Failure Reviews.
ISSN: 1573-7322
1382-4147
DOI: 10.1007/s10741-022-10281-3
Popis: Atrial fibrillation (AF) and atrial flutter (AFL) are associated with adverse outcomes in patients with heart failure and reduced ejection fraction (HFrEF). We investigated the effects of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on the incidence of AF and/or AFL in HFrEF patients. PubMed and ClinicalTrials.gov were systematically searched until March 2022 for randomized controlled trials (RCTs) that enrolled patients with HFrEF. A total of six RCTs with 9467 patients were included (N = 4731 in the SGLT2i arms; N = 4736 in the placebo arms). Compared to placebo, SGLT2i treatment was associated with a significant reduction in the risk of AF [relative risk (RR) 0.62, 95% confidence interval CI 0.44–0.86; P = 0.005] and AF/AFL (RR 0.64, 95% CI 0.47–0.87; P = 0.004). Subgroup analysis showed that empagliflozin use resulted in a significant reduction in the risk of AF (RR 0.55, 95% CI 0.34–0.89; P = 0.01) and AF/AFL (RR 0.50, 95% CI 0.32–0.77; P = 0.002). By contrast, dapagliflozin use was not associated with a significant reduction in the risk of AF (RR 0.69, 95% CI 0.43–1.11; P = 0.12) or AF/AFL (RR 0.82, 95% CI 0.53–1.27; P = 0.38). Additionally, a “shorter” duration (P = 0.02) and AF/AFL (P = 0.003). In conclusion, SGLT2i therapy was associated with a significant reduction in the risk of AF and AF/AFL in patients with HFrEF. These results reinforce the value of using SGLT2i in this setting.
Databáze: OpenAIRE
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