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Proietti, R, Rivera-Caravaca, JM, López-Gálvez, R, Harrison, SL, Marín, F, Underhill, P, Shantsila, E, McDowell, G, Vinciguerra, M, Davies, R, Giebel, C, Lane, DA and Lip, GYH (2023) Cerebrovascular, Cognitive and Cardiac Benefits of SGLT2 Inhibitors Therapy in Patients with Atrial Fibrillation and Type 2 Diabetes Mellitus: Results from a Global Federated Health Network Analysis. Journal of Clinical Medicine, 12 (8). ISSN 2077-0383
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Cerebrovascular, Cognitive and Cardiac Benefits of SGLT2 Inhibitors Therapy in Patients with Atrial Fibrillation.pdf - Published Version Available under License Creative Commons Attribution. Download (625kB) | Preview |
Abstract
Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are effective anti-diabetic drugs improving cardiovascular outcomes in type 2 diabetes mellitus (T2DM) patients. This study investigated cardiovascular, cerebrovascular and cognitive outcomes of SGLT2i therapy in patients with atrial fibrillation (AF) and T2DM. Methods: Observational study using TriNetX, a global health research network of anonymised electronic medical records from real-world patients between January 2018 and December 2019. The network includes healthcare organisations globally but predominately in the United States. AF patients (ICD-10-CM code: I48) with T2DM were divided according to SGLT2i use or not, and balanced using propensity score matching (PSM). Patients were followed-up for 3-years. The primary endpoints were ischaemic stroke/transient ischemic attack (TIA), intracranial haemorrhage (ICH), and incident dementia. Secondary endpoints were incident heart failure and mortality. Results: We identified 89,356 AF patients with T2DM of which 5061 (5.7%) were taking a SGLT2i. After PSM, 5049 patients (mean age 66.7 ± 10.6 years; 28.9% female) were included in each group. At 3-years follow-up, the risk of ischaemic stroke/TIA was higher in patients not receiving SGLT2i (HR 1.12, 95% CI 1.01–1.24) and for ICH (HR 1.57, 95% CI 1.25–1.99) and incident dementia (HR 1.66, 95% CI 1.30–2.12). Incident heart failure (HR 1.50, 95% CI 1.34–1.68) and mortality (HR 1.77, 95% CI 1.58–1.99) risks were increased in AF patients not receiving SGLT2i. Conclusions: In our large ‘real world’ analysis of patients with concomitant AF and T2DM, SGLT2i reduced the risk of cerebrovascular events, incident dementia, heart failure and death.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SGLT2; atrial fibrillation; dementia; stroke; 1103 Clinical Sciences |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RM Therapeutics. Pharmacology |
| Divisions: | Nursing & Allied Health Pharmacy & Biomolecular Sciences |
| Publisher: | MDPI AG |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 07 Jul 2023 15:24 |
| Last Modified: | 07 Jul 2023 15:30 |
| DOI or ID number: | 10.3390/jcm12082814 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/20278 |
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