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,Lawrence A. Leiter,Julia F Kuder,Sabina A. Murphy,Deepak L. Bhatt,Itamar Raz,Darren K. McGuire,John P.H. 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:142
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
桐桐应助noflatterer采纳,获得10
1秒前
2秒前
Akim应助虚幻的小海豚采纳,获得10
2秒前
图图烤肉完成签到,获得积分10
4秒前
4秒前
5秒前
小马甲应助fiee采纳,获得10
6秒前
风的忧伤完成签到,获得积分10
6秒前
daisy完成签到,获得积分10
7秒前
7秒前
淡然元珊发布了新的文献求助10
7秒前
7秒前
nini应助研友_LXd7JL采纳,获得10
7秒前
8秒前
彭于晏应助奶昔源采纳,获得10
8秒前
加菲丰丰举报斯文的樱桃求助涉嫌违规
9秒前
可爱的函函应助JJ采纳,获得10
10秒前
11秒前
cs完成签到 ,获得积分10
11秒前
李傲发布了新的文献求助10
12秒前
WIN发布了新的文献求助10
12秒前
kk完成签到,获得积分10
13秒前
LF-Scie发布了新的文献求助200
13秒前
简单夜玉发布了新的文献求助10
14秒前
七街完成签到 ,获得积分10
14秒前
大个应助小不遛w采纳,获得10
16秒前
梦希陌完成签到,获得积分10
16秒前
共享精神应助陶醉采纳,获得10
17秒前
17秒前
彭于晏应助李傲采纳,获得10
18秒前
白熊IceBear完成签到,获得积分10
18秒前
lazysheep完成签到,获得积分10
18秒前
阿婆家的傻小子完成签到,获得积分10
20秒前
20秒前
21秒前
HEIKU应助研友_LXd7JL采纳,获得10
22秒前
风起完成签到,获得积分10
22秒前
大熊完成签到 ,获得积分10
22秒前
想不到吧完成签到,获得积分10
23秒前
NexusExplorer应助孙一一采纳,获得30
23秒前
高分求助中
Sustainability in Tides Chemistry 2000
Microlepidoptera Palaearctica, Volumes 1 and 3 - 13 (12-Volume Set) [German] 1122
Дружба 友好报 (1957-1958) 1000
The Data Economy: Tools and Applications 1000
A Dissection Guide & Atlas to the Rabbit 600
中国心血管健康与疾病报告2023(要完整的报告) 500
Ожившие листья и блуждающие цветы. Практическое руководство по содержанию богомолов [Alive leaves and wandering flowers. A practical guide for keeping praying mantises] 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 3102382
求助须知:如何正确求助?哪些是违规求助? 2753656
关于积分的说明 7624478
捐赠科研通 2406188
什么是DOI,文献DOI怎么找? 1276717
科研通“疑难数据库(出版商)”最低求助积分说明 616918
版权声明 599103