SGLT2 inhibitors help prevent new-onset AF in diabetic Asians

Use of sodium-glucose cotransporter 2 inhibitors (SGLT2is) may reduce the risk of new-onset atrial fibrillation (AF) relative to glucagon-like peptide-1 receptor agonists (GLP-1RAs) in Asian patients with type 2 diabetes mellitus (T2DM) in a real-world practice, reports a recent study.

The authors sought to determine the comparative risk of new-onset AF with SGLT2is vs GLP-1RAs in Asians with T2DM in a real-world setting. They used medical data from a multicentre healthcare provider in Taiwan and enrolled 16,566 patients treated with an SGLT2i and 2,746 with GLP-1RA from 1 January 2016 and 31 December 2018.

To balance the baseline covariates, the authors used propensity score weighting. They followed patients from the drug index data until the occurrence of new-onset AF or the end of the follow-up period.

Among patients treated with an SGLT2i, 54 percent received empagliflozin, 45 percent dapagliflozin, and 1 percent canagliflozin. On the other hand, 65 percent and 35 percent of GLP-1RA‒treated patients received liraglutide and dulaglutide, respectively.

After inverse probability of treatment weighting, treatment with SGLT2is led to a reduced risk of new-onset AF compared with GLP-1RAs (subdistribution hazard ratio, 0.72, 95 percent confidence interval [CI], 0.54‒0.97; p=0.028).

Notably, this finding was consistent in a subgroup analysis of older patients, female patients, and those with cardiovascular disease or chronic kidney disease.