Key result
Second-line TZDs are linked to ~24% lower AF risk vs other antidiabetic drugs.
Why the study?
Diabetes mellitus increases the risk of atrial fibrillation, and it is unclear whether thiazolidinediones reduce this risk compared with other antidiabetic drugs.
Do thiazolidinediones reduce the risk of atrial fibrillation in diabetic patients compared with other second-line antidiabetic drugs?
Population
108,624 diabetic patients without prior AF treated with metformin or sulfonylurea as first-line drugs
Comparison
Thiazolidinediones vs other second-line antidiabetic drugs
Design
Nationwide cohort study using Danish registries
Follow-up
10 years
Authors
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May suggest lower AF risk with thiazolidinediones in diabetes; hypothesis-generating and should not change practice without RCTs.
Cohort (n=108,624)
Do thiazolidinediones reduce the risk of atrial fibrillation in diabetic patients compared with other second-line antidiabetic drugs?
Hazard Ratio: 0.76 (95% CI 0.57–1)
Absolute Event Rate: 6.2% vs 10.2%
p-value: p=0.047
Thiazolidinediones as second-line therapy in diabetic patients are associated with a significantly reduced risk of developing atrial fibrillation compared to other antidiabetic drugs.
Pallisgaard et al. (2016) conducted a cohort in Diabetes mellitus (n=108,624). Thiazolidinediones (TZDs) vs. Other second-line antidiabetic drugs was evaluated on Incidence of atrial fibrillation (HR 0.76, 95% CI 0.57-1.00, p=0.047). Thiazolidinediones as second-line antidiabetic treatment were associated with a decreased risk of atrial fibrillation compared with other antidiabetic drugs (HR 0.76; 95% CI 0.57-1.00; P=0.047).
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