PMID- 33941171
OWN - NLM
STAT- MEDLINE
DCOM- 20211101
LR  - 20211101
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 20
IP  - 1
DP  - 2021 Apr 30
TI  - The impact of weight loss related to risk of new-onset atrial fibrillation in 
      patients with type 2 diabetes mellitus treated with sodium-glucose cotransporter 
      2 inhibitor.
PG  - 93
LID - 10.1186/s12933-021-01285-8 [doi]
LID - 93
AB  - BACKGROUND: Sodium-glucose cotransporter 2 inhibitor (SGLT2i) use reduces body 
      weight (BW) in patients with type 2 diabetes mellitus (T2DM). Obesity and T2DM 
      are strong risk factors of new-onset atrial fibrillation (AF). However, whether 
      BW loss following SGLT2i treatment reduces AF risk in patients with T2DM remains 
      unclear. METHODS: We used a medical database from a multicenter health care 
      provider in Taiwan, which included 10,237 patients with T2DM, from June 1, 2016 
      to December 31, 2018, whose BW data at baseline and at 12 weeks of SGLT2i 
      treatment were available. Patients were followed up from the drug index date 
      until the occurrence of new-onset AF, discontinuation of the SGLT2i, or the end 
      of the study period, whichever occurred first. RESULTS: The patients' baseline 
      body mass index (BMI) was 28.08 [Formula: see text] 4.88 kg/m(2). SGLT2i 
      treatment was associated with a BW loss of 1.35 [Formula: see text] 3.28 kg 
      (1.78%[Formula: see text] 4.47%). There were 37.4%, 47.0%, and 15.6% of patients 
      experienced no-BW loss (n = 3832), BW loss 0.0-4.9% (n = 4814), and [Formula: see 
      text] 5.0% (n = 1591) following SGLT2i treatment, respectively. Compared with 
      patients with baseline BMI < 23 kg/m(2), AF risk significantly increased in 
      patients with baseline BMI [Formula: see text] 27.5 kg/m(2) (P for 
      trend = 0.015). Compared with those without BW loss after SGLT2i treatment, AF 
      risk significantly decreased with a BW loss of [Formula: see text] 5.0% (adjusted 
      hazard ratios [95% confidence intervals]: 0.39[0.22-0.68]). Use of diuretics, old 
      age, high-dose SGLT2i, higher estimated glomerular filtration rate, and baseline 
      BMI were independent factors associated with a BW loss of [Formula: see text] 
      5.0% following SGLT2i initiation. By contrast, neither baseline BMI nor BW loss 
      after SGLT2i treatment predicted major cardiovascular adverse events or heart 
      failure hospitalization risk (P for trend > 0.05). CONCLUSION: BW loss of >/= 5.0% 
      following SGLT2i treatment was associated with a lower risk of new-onset AF in 
      patients with T2DM in real-world practice.
FAU - Chan, Yi-Hsin
AU  - Chan YH
AD  - The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, 
      33305, Taiwan.
AD  - College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan.
AD  - Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, 
      Taiwan.
FAU - Chen, Shao-Wei
AU  - Chen SW
AD  - Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Linkou 
      Medical Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 
      City, Taiwan.
AD  - Center for Big Data Analytics and Statistics, Linkou Medical Center, Chang Gung 
      Memorial Hospital, Taoyuan City, Taiwan.
FAU - Chao, Tze-Fan
AU  - Chao TF
AD  - Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 
      Taipei, Taiwan.
AD  - Institute of Clinical Medicine, Cardiovascular Research Center, National Yang 
      Ming Chiao Tung University, Taipei, Taiwan.
FAU - Kao, Yi-Wei
AU  - Kao YW
AD  - Graduate Institute of Business Administration, College of Management, Fu Jen 
      Catholic University, Taipei, Taiwan.
FAU - Huang, Chien-Ying
AU  - Huang CY
AD  - The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, 
      33305, Taiwan.
FAU - Chu, Pao-Hsien
AU  - Chu PH
AD  - The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, 
      33305, Taiwan. taipei.chu@gmail.com.
AD  - College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan. 
      taipei.chu@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20210430
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
SB  - IM
MH  - Aged
MH  - Atrial Fibrillation/*chemically induced/diagnosis/epidemiology/prevention & 
      control
MH  - Body Mass Index
MH  - Databases, Factual
MH  - Diabetes Mellitus, Type 2/diagnosis/*drug therapy/epidemiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Protective Factors
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Sodium-Glucose Transporter 2 Inhibitors/*adverse effects
MH  - Taiwan/epidemiology
MH  - Time Factors
MH  - Treatment Outcome
MH  - Weight Loss/*drug effects
PMC - PMC8091721
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - Heart failure
OT  - Obesity
OT  - Sodium-glucose cotransporter-2 inhibitor
OT  - Type 2 diabetes mellitus
COIS- The authors declare that they have no competing interests.
EDAT- 2021/05/05 06:00
MHDA- 2021/11/03 06:00
PMCR- 2021/04/30
CRDT- 2021/05/04 05:51
PHST- 2021/03/10 00:00 [received]
PHST- 2021/04/20 00:00 [accepted]
PHST- 2021/05/04 05:51 [entrez]
PHST- 2021/05/05 06:00 [pubmed]
PHST- 2021/11/03 06:00 [medline]
PHST- 2021/04/30 00:00 [pmc-release]
AID - 10.1186/s12933-021-01285-8 [pii]
AID - 1285 [pii]
AID - 10.1186/s12933-021-01285-8 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2021 Apr 30;20(1):93. doi: 10.1186/s12933-021-01285-8.