What question did this study set out to answer?

This research aims to evaluate the effects of sodium glucose co-transporter 2 inhibitors on complications in atrial fibrillation patients.

February 14, 2026Open Access

Impact of sodium glucose co-transporter 2 inhibitors on bleeding, hospitalizations and other adverse outcomes in atrial fibrillation patients with and without diabetes

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation (n=102640). Intervention: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) vs. Non-SGLT2i use. Primary outcome: Bleeding (HR 0.669, 95% CI 0.642-0.697, p=<0.001).

Q: What does this research mean for the field?

Sodium-glucose cotransporter 2 inhibitors are associated with a 33% lower risk of bleeding compared to non-use in anticoagulated patients with atrial fibrillation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Sodium-glucose cotransporter 2 inhibitors were associated with a 33% lower risk of bleeding (HR 0.669) compared to non-use in anticoagulated patients with atrial fibrillation.

Key Points

This research aims to evaluate the effects of sodium glucose co-transporter 2 inhibitors on complications in atrial fibrillation patients.
Analyzed medical records of atrial fibrillation patients
Compared outcomes in those treated with SGLT2 inhibitors versus those not treated
Monitored for adverse outcomes including bleeding and hospitalization rates
SGLT2 inhibitor use is linked to a reduced risk of AF-related complications
Lower hospitalization rates observed in patients using SGLT2 inhibitors
Notable decrease in bleeding events among SGLT2 inhibitor users

Study Design

Type

Cohort (n=102,640)

Multicenter

Yes

Structured PICO

Does SGLT2i use reduce bleeding, hospitalizations, and other adverse outcomes in anticoagulated patients with atrial fibrillation?

Population

876,007 anticoagulated patients with atrial fibrillation (AF) between January 1, 2014 and December 31, 2020 (102,640 patients after propensity score matching), mean age ~70 years, multinational (7 countries, majority United States, also Germany, United Kingdom, Italy, Singapore, Israel).

Intervention

Sodium glucose co-transporter 2 inhibitors (SGLT2i) as a class

Comparator

No SGLT2i use (1:1 propensity score matched cohort)

Outcome

Bleeding events, hospitalizations for AF / flutter, composite of cardioversion and ablations, and ventricular arrhythmias and cardiac arrests over a 3-year follow-up periodcomposite

In a large real-world cohort of anticoagulated patients with atrial fibrillation, SGLT2 inhibitor use was associated with significantly lower risks of bleeding, AF-related hospitalizations, arrhythmias, and mortality.

Main Result

Effect estimate: HR 0.669 (95% CI 0.642-0.697)

Absolute Event Rate: 7.5% vs 11.8%

p-value: p=<0.001

Limitations

Residual confounding and potential data inaccuracies inherent to retrospective analyses
Potential underreporting of certain characteristics like smoking history
Hospitalizations or procedures at non-participating sites may not have been captured
Inability to determine duration of SGLT2i use prior to follow-up
Unable to compare outcomes for individual SGLT2is or according to type and duration of atrial fibrillation

Abstract

SGLT2i use was associated with a lower risk of AF-related complications.

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Discussion

Authors

Ameenathul M. Fawzy

A. Bisson

Université de Tours

Laurent Fauchier

Journals

Polskie Archiwum Medycyny Wewnętrznej

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References and Citations

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Impact of sodium glucose co-transporter 2 inhibitors on bleeding, hospitalizations and other adverse outcomes in atrial fibrillation patients with and without diabetes

Key Result

Key Points

Study Design

Structured PICO

Main Result

Limitations

Abstract

Citation Network

Connected Papers

Discussion

Authors

Journals

Actions

References and Citations

Citation Network

Connected Papers

Discussion

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