SGLT2i effect on atrial fibrillation: A network meta‐analysis of randomized controlled trials

医学 心房颤动 随机对照试验 荟萃分析 心脏病学 内科学 梅德林 政治学 法学
作者
Marco Valerio Mariani,Giovanna Manzi,Nicola Pierucci,Domenico Laviola,Agostino Piro,Andrea D’Amato,Domenico Filomena,Andrea Matteucci,Paolo Severino,Fabio Miraldi,Carmine Dario Vizza,Carlo Lavalle
出处
期刊:Journal of Cardiovascular Electrophysiology [Wiley]
卷期号:35 (9): 1754-1765 被引量:24
标识
DOI:10.1111/jce.16344
摘要

Abstract Introduction Gliflozins are recommended as first‐line treatment in patients with heart failure and/or cardiovascular comorbidities and are demonstrated to reduce atrial fibrillation (AF) occurrence. However, it is not well known which gliflozin yields the larger cardioprotection in terms of AF occurrence reduction. Hence, we aimed to compare data regarding AF recurrence associated with different gliflozins. Methods An accurate search of online scientific libraries (from inception to June 1, 2023) was performed. Fifty‐nine studies were included in the meta‐analysis involving 108 026 patients, of whom 60 097 received gliflozins and 47 929 received placebo. Results Gliflozins provided a statistically significant reduction of AF occurrence relative to standard of care therapy in the overall population (relative risks [RR]: 0.8880, 95% CI: [0.8059; 0.9784], p = .0164) and in patients with diabetes and cardiorenal diseases (RR: 0.8352, 95% CI: [0.7219; 0.9663], p = .0155). Dapagliflozin significantly decreased AF occurrence as compared to placebo (0.7259 [0.6337; 0.8316], p < .0001) in the overall population, in patients with diabetes (RR: 0.2482, 95% CI: [0.0682; 0.9033], p = .0345), with diabetes associated with cardiorenal diseases (RR: 0.7192, 95% CI: [0.5679; 0.9110], p = .0063) and in the subanalysis including studies with follow‐up ≥1 year (RR: 0.7792, 95% CI: [0.6508; 0.9330], p = .0066). No significant differences in terms of AF protection were found among different gliflozins. Conclusions Dapagliflozin use was associated with significant reduction in AF risk as compared to placebo in overall population and patients with diabetes, whereas the use of other gliflozins did not significantly reduce AF occurrence.
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