Key result
GLP-1RAs are linked to ~8% lower new-onset AF risk in diabetes.
Why the study?
GLP-1RAs improve cardiometabolic outcomes in type 2 diabetes and obesity, but their association with new-onset AF remains uncertain.
Does GLP-1RA initiation reduce new-onset atrial fibrillation in adults with diabetes or obesity?
Cohort (n=309,874)
Yes
Does GLP-1RA initiation reduce new-onset atrial fibrillation in adults with diabetes or obesity?
Hazard Ratio: 0.924 (95% CI 0.881–0.969)
GLP-1RA therapy is associated with a reduced risk of new-onset atrial fibrillation in adults with diabetes or obesity compared to other active treatments.
May lower new-onset AF risk in diabetes or obesity; leaves open whether association is causal or warrants practice change.
AIMS: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) improve cardiometabolic outcomes in type 2 diabetes and obesity, but their association with new-onset atrial fibrillation (AF) remains uncertain. This study examined whether GLP-1RA use is associated with AF risk in adults with diabetes or obesity. METHODS: We conducted a multinational retrospective cohort study using the TriNetX Analytics Network, aggregating de-identified electronic health records from over 220 healthcare organizations in 30 countries. Adults aged ≥ 20 years with diabetes or obesity were included between 2017 and 2021 and followed for up to three years. GLP-1RA initiators were compared with non-GLP-1RA active comparators after 1:1 propensity score matching. Cox models estimated hazard ratios (HRs) for new-onset AF identified by ICD-10 codes after a 90-day exclusion window. RESULTS: After matching, 137,200 patients were included per group in the diabetes cohort and 17,737 per group in the obesity cohort. In diabetes, GLP-1RA use was associated with lower AF risk (HR 0.924; 95% CI 0.881-0.969), greatest versus DPP-4 inhibitors (HR 0.723; 95% CI 0.675-0.774). In obesity, AF risk was lower versus non-sympathomimetic agents (HR 0.765; 95% CI 0.628-0.933). CONCLUSIONS: GLP-1RA therapy was associated with reduced incidence of new-onset AF, particularly among adults with diabetes.
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Weng et al. (2026) conducted a cohort in diabetes or obesity (n=309,874). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) vs. non-GLP-1RA active comparators was evaluated on new-onset atrial fibrillation (HR 0.924, 95% CI 0.881-0.969). GLP-1RA use was associated with a lower risk of new-onset atrial fibrillation in adults with diabetes (HR 0.924; 95% CI 0.881-0.969) and obesity (HR 0.765; 95% CI 0.628-0.933).
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