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Sodium‐glucose co‐transporter‐2 inhibitors and atrial fibrillation in the cardiovascular and renal outcome trials
Author(s) -
Okunrintemi Victor,
Mishriky Basem M.,
Powell James R.,
Cummings Doyle M.
Publication year - 2021
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.14211
Subject(s) - medicine , dapagliflozin , atrial fibrillation , incidence (geometry) , placebo , population , relative risk , diabetes mellitus , adverse effect , hazard ratio , empagliflozin , atrial flutter , confidence interval , cardiology , type 2 diabetes , endocrinology , physics , alternative medicine , environmental health , pathology , optics
Abstract Dapagliflozin is a sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor that has recently been shown to reduce the incidence of reported episodes of atrial fibrillation (AF)/atrial flutter in the DECLARE‐TIMI 58 trial. This raises the question regarding whether SGLT2 inhibitors can reduce the incidence of AF in a high‐risk population. We searched for trials comparing SGLT2 inhibitors to placebo in high‐risk individuals with or without diabetes (ie, cardiovascular and renal outcome trials) and that reported the incidence of AF as a serious adverse event. The EMPA‐REG OUTCOME trial, CANVAS, CANVAS‐R, the DECLARE‐TIMI 58 trial, CREDENCE, DAPA‐HF, VERTIS‐CV and DAPA‐CKD were included. The incidence of AF, reported as a serious adverse event, was 0.9% in individuals who received an SGLT2 inhibitor compared to 1.1% in those who received placebo. Pooled results showed a significantly lower incidence of AF in individuals with and without diabetes (relative risk 0.79, 95% confidence interval 0.67,0.93). This review suggests that there is a significantly lower risk of incident AF for individuals on SGLT2 inhibitors versus placebo. While there was a statistically significant lower incidence of AF, reported as a serious adverse event, more research is needed to evaluate its clinical significance.