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The impact of sodium-glucose co-transporter-2 inhibitors on dementia and cardiovascular events in diabetic patients with atrial fibrillation

Chen, YY, Chang, HC, Lin, YJ, Chien, KL, Hsieh, YC, Chung, FP, Lin, CH, Lip, GYH and Chen, SA (2024) The impact of sodium-glucose co-transporter-2 inhibitors on dementia and cardiovascular events in diabetic patients with atrial fibrillation. Diabetes/Metabolism Research and Reviews, 40 (2). e3775. ISSN 1520-7552

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Aims: The effectiveness of sodium-glucose co-transporter-2 inhibitors (SGLT2i) on incident dementia in patients with diabetes and atrial fibrillation (AF) remains unknown. This study aimed to investigate the association between SGLT2i and the risk of incident dementia in diabetic patients with AF, and to explore the interactions with oral anticoagulants or dipeptidyl peptidase-4 inhibitors (DPP4i). Materials and Methods: We conducted a cohort study using Taiwan's National Health Insurance Research Database. Patients with diabetes and AFwithout a prior history of established cardiovascular diseases, were identified. Using propensity score matching, 810 patients receiving SGLT2i were matched with 1620 patients not receiving SGLT2i. The primary outcome was incident dementia, and secondary outcomes included composite cardiovascular events and mortality. Results: After up to 5 years of follow-up, SGLT2i use was associated with a significantly lower risk of incident dementia (hazard: 0.71, 95% confidence interval: 0.51–0.98), particularly vascular dementia (HR: 0.44, 95% CI: 0.24–0.82). SGLT2i was related to reduced risks of AF-related hospitalisation (HR: 0.72, 95% CI: 0.56–0.93), stroke (HR: 0.75, 95% CI: 0.60–0.94), and all-cause death (HR: 0.33, 95% CI: 0.24–0.44). The protective effects were consistent irrespective of the concurrent use of non-vitamin K antagonist oral anticoagulants (NOACs) or DPP4i. Conclusions: In diabetic patients with AF, SGLT2i was associated with reduced risks of incident dementia, AF-related hospitalisation, stroke, and all-cause death. The protective effects were independent of either concurrent use of NOACs or DPP4i.

Item Type: Article
Uncontrolled Keywords: Humans; Dementia; Atrial Fibrillation; Diabetes Mellitus; Diabetes Mellitus, Type 2; Sodium; Glucose; Symporters; Anticoagulants; Hypoglycemic Agents; Administration, Oral; Retrospective Studies; Cohort Studies; Stroke; Dipeptidyl-Peptidase IV Inhibitors; Sodium-Glucose Transporter 2 Inhibitors; atrial fibrillation; cardiovascular events; dementia; diabetes mellitus; sodium-glucose cotransporter-2 inhibitors; Humans; Atrial Fibrillation; Administration, Oral; Cohort Studies; Anticoagulants; Diabetes Mellitus; Dipeptidyl-Peptidase IV Inhibitors; Sodium-Glucose Transporter 2 Inhibitors; Stroke; Symporters; Dementia; Glucose; Sodium; Diabetes Mellitus, Type 2; Hypoglycemic Agents; Retrospective Studies; 1103 Clinical Sciences; Endocrinology & Metabolism
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > R Medicine (General)
Divisions: Nursing & Allied Health
Publisher: Wiley
SWORD Depositor: A Symplectic
Date Deposited: 12 Mar 2024 11:47
Last Modified: 12 Mar 2024 11:47
DOI or ID number: 10.1002/dmrr.3775
URI: https://researchonline.ljmu.ac.uk/id/eprint/22783
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