Type 2 diabetes mellitus (DM) and atrial fibrillation (AF) are 2 of the great epidemics
of our time. DM affects an estimated 8.5% of adults in the United States
1
and is associated with an increased risk of cardiovascular events, including AF.
2
AF in turn affects up to an estimated 12.5% of adults older than 65 years in the
United States, decreases quality of life, and increases the risks of heart failure,
stroke, and death.
3
,4
In 2015, the EMPA-REG OUTCOME (BI 10773 [Empagliflozin] Cardiovascular Outcome Event
Trial in Type 2 Diabetes Mellitus Patients) randomized controlled trial (RCT), which
assessed the sodium glucose cotransporter 2 inhibitor SGLT-2i, sparked interest in
the therapeutic potential of oral antidiabetic agents in reducing cardiovascular outcomes.
5
Since then, several other SGLT-2i trials have shown consistent reductions in heart
failure hospitalizations, cardiovascular death, and/or major adverse cardiovascular
outcomes compared to placebo.
6
However, the impact of SGLT-2is and other oral antidiabetic agents on AF is less
clear.To read this article in full you will need to make a payment
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References
- Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study.BMJ. 2018; 362: k1497
- Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation.Am J Cardiol. 2011; 108: 56-62
- Atrial fibrillation as an independent risk factor for stroke: the Framingham Study.Stroke. 1991; 22: 983-988
- Perception of atrial fibrillation before and after radiofrequency catheter ablation: relevance of asymptomatic arrhythmia recurrence.Circulation. 2005; 112: 307-313
- Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes.N Engl J Med. 2015; 373: 2117-2128
- Comparison of the effect of glucose-lowering agents on the risk of atrial fibrillation: a network meta-analysis.Heart Rhythm. 2021; 18: 1090-1096
- Network Meta-Analysis for Decision-Making.Wiley, Oxford2018
- Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial.Eur Heart J. 2018; 39: 2987-2996
Article info
Publication history
Published online: April 07, 2021
Footnotes
Funding sources: The authors have no funding sources to disclose.
Disclosures: The authors have no conflicts of interest to disclose.
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