Key result
DOACs, SGLT2 inhibitors, and GLP-1RAs offer improved cardiovascular safety and efficacy in AF and diabetes.
This review synthesizes evidence on managing atrial fibrillation in diabetic patients, emphasizing DOACs for stroke prevention and the nuanced role of modern hypoglycemic therapies in arrhythmia management.
The article analyzes the main clinical and theoretical data on the features of the treatment of atrial fibrillation (AF) in combination with diabetes mellitus (DM). Differentiated approaches to the correction of these cardiac arrhythmias in this category of patients are considered, among which the methods of first choice are hypoglycemic therapy and catheter ablation. Currently, in addition to metformin, which is the basis for the treatment of most patients with type 2 diabetes, new classes of drugs are used: sodium glucose co-transporter-2 (SGLT2) inhibitors, agonists of the receptor for glucagon-like peptide-1 (aGPP-1), dipeptidyl peptidase 4 (DPP-4) inhibitors. The results of randomized trials performed using these classes of drugs have shown different levels of cardiac efficacy and safety in the treatment of patients with AF.
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Serik et al. (2022) conducted a review in Atrial fibrillation and diabetes mellitus. Direct oral anticoagulants and novel hypoglycemic agents vs. Warfarin and traditional hypoglycemic agents was evaluated. Direct oral anticoagulants and novel hypoglycemic agents such as SGLT-2 inhibitors and GLP-1 receptor agonists offer improved cardiovascular safety and efficacy in patients with atrial fibrillation and diabetes.
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