Effect of Dapagliflozin on Atrial Fibrillation in Patients With Type 2 Diabetes Mellitus

达帕格列嗪 医学 内科学 心房颤动 心脏病学 糖尿病 心肌梗塞 2型糖尿病 心力衰竭 危险系数 心房扑动 2型糖尿病 内分泌学 置信区间
作者
Thomas A. Zelniker,Marc P. Bonaca,Remo H.M. Furtado,Ofri Mosenzon,Julia Kuder,Sabina A. Murphy,Deepak L. Bhatt,Lawrence A. Leiter,Darren K. McGuire,John Wilding,Andrzej Budaj,Róbert Gábor Kiss,Francisco Padilla,Ingrid Gause‐Nilsson,Anna Maria Langkilde,Itamar Raz,Marc S. Sabatine,Stephen D. Wiviott
出处
期刊:Circulation [Ovid Technologies (Wolters Kluwer)]
卷期号:141 (15): 1227-1234 被引量:301
标识
DOI:10.1161/circulationaha.119.044183
摘要

Background: Atrial fibrillation (AF) and atrial flutter (AFL) are associated with both diabetes mellitus and its related comorbidities, including hypertension, obesity, and heart failure (HF). SGLT2 (sodium-glucose cotransporter 2) inhibitors have been shown to lower blood pressure, reduce weight, have salutary effects on left ventricular remodeling, and reduce hospitalization for HF and cardiovascular death in patients with type 2 diabetes mellitus. We therefore investigated whether SGLT2 inhibitors could also reduce the risk of AF/AFL. Methods: DECLARE-TIMI 58 (Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction 58) studied the efficacy and safety of the SGLT2 inhibitor dapagliflozin versus placebo in 17 160 patients with type 2 diabetes mellitus and either multiple risk factors for atherosclerotic cardiovascular disease (n=10 186) or known atherosclerotic cardiovascular disease (n=6974). We explored the effect of dapagliflozin on the first and total number of AF/AFL events in patients with (n=1116) and without prevalent AF/AFL using Cox and negative binomial models, respectively. AF/AFL events were identified by search of the safety database using MedDRA preferred terms (“atrial fibrillation,” “atrial flutter”). Results: Dapagliflozin reduced the risk of AF/AFL events by 19% (264 versus 325 events; 7.8 versus 9.6 events per 1000 patient-years; hazard ratio [HR], 0.81 [95% CI, 0.68–0.95]; P =0.009). The reduction in AF/AFL events was consistent regardless of presence or absence of a history of AF/AFL at baseline (previous AF/AFL: HR, 0.79 [95% CI, 0.58–1.09]; no AF/AFL: HR, 0.81 [95% CI, 0.67–0.98]; P for interaction 0.89). Similarly, presence of atherosclerotic cardiovascular disease (HR, 0.83 [95% CI, 0.66–1.04]) versus multiple risk factors (HR, 0.78 [95% CI, 0.62–0.99]; P for interaction 0.72) or a history of HF (HF: HR, 0.78 [95% CI, 0.55–1.11]; No HF: HR, 0.81 [95% CI, 0.68–0.97]; P for interaction 0.88) did not modify the reduction in AF/AFL events observed with dapagliflozin. Moreover, there was no effect modification by sex, history of ischemic stroke, glycated hemoglobin A 1c , body mass index, blood pressure, or estimated glomerular filtration rate (all P for interaction >0.20). Dapagliflozin also reduced the total number (first and recurrent) of AF/AFL events (337 versus 432; incidence rate ratio, 0.77 [95% CI, 0.64–0.92]; P =0.005). Conclusions: Dapagliflozin decreased the incidence of reported episodes of AF/AFL adverse events in high-risk patients with type 2 diabetes mellitus. This effect was consistent regardless of the patient’s previous history of AF, atherosclerotic cardiovascular disease, or HF. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01730534.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Luo完成签到,获得积分10
刚刚
1秒前
ding应助宠仙采纳,获得10
2秒前
zhangxinyu发布了新的文献求助10
4秒前
4秒前
欣慰的赛凤完成签到,获得积分10
11秒前
16秒前
大模型应助不安的松采纳,获得10
18秒前
19秒前
19秒前
科研通AI2S应助渣渣XM采纳,获得10
21秒前
调皮飞绿完成签到,获得积分20
21秒前
Ava应助Dazzein采纳,获得10
23秒前
科研通AI2S应助逢投必中采纳,获得10
23秒前
小坚果完成签到,获得积分20
24秒前
liuerlong完成签到 ,获得积分10
24秒前
26秒前
26秒前
情怀应助realha采纳,获得10
26秒前
26秒前
俞渝完成签到,获得积分20
27秒前
28秒前
小坚果发布了新的文献求助10
29秒前
论文制造机完成签到 ,获得积分10
30秒前
康康乃馨完成签到 ,获得积分10
31秒前
haowu发布了新的文献求助10
32秒前
开朗孤兰发布了新的文献求助10
32秒前
早发论文应助酷酷碧采纳,获得10
32秒前
32秒前
兴奋的若菱完成签到 ,获得积分10
34秒前
思源应助调皮飞绿采纳,获得10
34秒前
Dazzein发布了新的文献求助10
35秒前
35秒前
36秒前
淡淡的若冰应助Rigel采纳,获得20
36秒前
Time发布了新的文献求助10
38秒前
完美世界应助sdahjjyk采纳,获得10
39秒前
小陈老板发布了新的文献求助10
39秒前
今后应助不会飞的大圣采纳,获得10
39秒前
Dazzein完成签到,获得积分10
39秒前
高分求助中
Evolution 10000
юрские динозавры восточного забайкалья 800
English Wealden Fossils 700
Mantiden: Faszinierende Lauerjäger Faszinierende Lauerjäger 600
Distribution Dependent Stochastic Differential Equations 500
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
A new species of Velataspis (Hemiptera Coccoidea Diaspididae) from tea in Assam 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3157455
求助须知:如何正确求助?哪些是违规求助? 2808877
关于积分的说明 7878686
捐赠科研通 2467233
什么是DOI,文献DOI怎么找? 1313279
科研通“疑难数据库(出版商)”最低求助积分说明 630380
版权声明 601919