Sodium-glucose cotransporter 2 inhibitors (SGLT2is) show a consistent reduction in atrial fibrillation risk in observational studies, while randomized controlled trials have yielded mixed results.
Does SGLT2is reduce prevalence, incidence of new-onset, and recurrence of AF in diabetic populations and patients with HF?
Current evidence on the impact of SGLT2 inhibitors on atrial fibrillation is inconclusive, with observational studies suggesting benefit but RCTs yielding mixed results.
Atrial fibrillation (AF) is the most prevalent arrhythmia among adults worldwide, frequently co-occurring with comorbidities such as Heart Failure (HF) and Type 2 Diabetes Mellitus (T2DM). This association contributes to increased morbidity and mortality, elevated healthcare costs, and diminished quality of life. Consequently, preventing or delaying the onset and recurrence of AF is crucial for reducing the incidence of complications. Sodium-glucose cotransporter 2 inhibitors (SGLT2is), due to their multifaceted pharmacological actions, have been proposed as potential therapeutic agents in the management of AF. However, current evidence from both animal models and clinical studies remains inconclusive. This narrative literature review aims to provide a comprehensive analysis of existing evidence on the impact of SGLT2is on the prevalence, incidence of new-onset, and recurrence of AF in diabetic populations and patients with HF. Numerous observational studies, predominantly retrospective, suggest a consistent reduction in AF risk with SGLT2is, while randomized controlled trials (RCTs) have yielded mixed results, with some demonstrating benefits and others not reaching statistical significance. The heterogeneity in study outcomes, population characteristics, follow-up duration, and specific SGLT2is used, as well as potential biases, underscore the need for further extensive and rigorous RCTs to establish definitive conclusions and elucidate the underlying mechanisms.
Stachteas et al. (Thu,) conducted a review in Atrial fibrillation. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) was evaluated on Prevalence, incidence of new-onset, and recurrence of atrial fibrillation. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) show a consistent reduction in atrial fibrillation risk in observational studies, while randomized controlled trials have yielded mixed results.