PMID- 37798123 OWN - NLM STAT- MEDLINE DCOM- 20240219 LR - 20240219 IS - 2047-4881 (Electronic) IS - 2047-4873 (Linking) VI - 31 IP - 3 DP - 2024 Feb 15 TI - Clinical outcomes with the use of sodium-glucose cotransporter-2 inhibitors in patients with atrial fibrillation and type 2 diabetes mellitus: a multi-centre, real-world cohort study. PG - 320-329 LID - 10.1093/eurjpc/zwad322 [doi] AB - AIMS: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have been shown to improve cardiovascular outcomes and reduce the incidence of atrial fibrillation (AF) in patients with type 2 diabetes mellitus (T2DM). We investigated the clinical outcomes with and without the use of SGLT2is in patients with T2DM and concomitant AF. METHODS AND RESULTS: We derived patient data from a clinical data warehouse constructed from the electronic medical records of seven medical centres. Data for 11 012 patients diagnosed with both AF and T2DM were analysed. New SGLT2i users were classified into the SGLT2i group and those who were not prescribed SGLT2is were classified into the control group. We performed a 1:2 propensity score (PS)-matching analysis. The primary endpoint was a composite of all-cause death or hospitalization due to heart failure (HF) events in 3 years. The PS-matched population consisted of 1115 patients in the SGLT2i group and 2050 patients in the control group. Incidence of the primary endpoint was significantly lower in the SGLT2i group [8.4 vs. 14.6%, hazard ratio (HR) 0.69, 95% confidence interval (CI) 0.55-0.87]. Sodium-glucose cotransporter-2 inhibitors use was associated with significantly lower all-cause mortality (HR 0.43, 95% CI 0.29-0.67) and HF hospitalization (HR 0.77, 95% CI 0.59-0.99). Adverse renal events, defined as >50% increase in serum creatinine level or initiation of dialysis, occurred less often in the SGLT2i group (HR 0.50, 95% CI 0.38-0.66, P < 0.001). CONCLUSION: Use of SGLT2is in patients with T2DM and concomitant AF was associated with reduced mortality or HF hospitalization events. CI - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Jang, Jaehyuk AU - Jang J AD - Division of Cardiology, Department of Internal Medicine, Uijeongbu St.Mary's Hospital, College of Medicine, The Catholic University of Korea, 271 Cheonboro, Uijeongbu, Gyeonggido 11765, South Korea. AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. FAU - Park, Soyoon AU - Park S AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. AD - Division of Cardiology, Department of Internal Medicine, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. FAU - Kim, Soohyun AU - Kim S AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. AD - Division of Cardiology, Department of Internal Medicine, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. FAU - Kim, Sung-Hwan AU - Kim SH AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. AD - Division of Cardiology, Department of Internal Medicine, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. FAU - Oh, Yong-Seog AU - Oh YS AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. AD - Division of Cardiology, Department of Internal Medicine, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. FAU - Sa, Young Kyoung AU - Sa YK AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. AD - Division of Cardiology, Department of Internal Medicine, Yeouido St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. FAU - Hwang, Youmi AU - Hwang Y AUID- ORCID: 0000-0001-8385-6485 AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. AD - Division of Cardiology, Department of Internal Medicine, St.Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea. FAU - Jang, Sung-Won AU - Jang SW AUID- ORCID: 0000-0001-5272-0665 AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. AD - Division of Cardiology, Department of Internal Medicine, Eunpyeong St.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. FAU - Ihm, Sang-Hyun AU - Ihm SH AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. AD - Division of Cardiology, Department of Internal Medicine, Bucheon St.Mary's Hospital, The Catholic University of Korea, Bucheon, South Korea. FAU - Choi, Young AU - Choi Y AUID- ORCID: 0000-0003-3900-1943 AD - Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. AD - Division of Cardiology, Department of Internal Medicine, Seoul St.Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul 06591, South Korea. LA - eng GR - Research Fund of Seoul St. Mary's Hospital/ GR - Catholic University of Korea/ PT - Journal Article PT - Multicenter Study PL - England TA - Eur J Prev Cardiol JT - European journal of preventive cardiology JID - 101564430 RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) RN - IY9XDZ35W2 (Glucose) RN - 9NEZ333N27 (Sodium) SB - IM MH - Humans MH - *Atrial Fibrillation/diagnosis/drug therapy/epidemiology MH - *Sodium-Glucose Transporter 2 Inhibitors/adverse effects MH - *Diabetes Mellitus, Type 2/complications/diagnosis/drug therapy MH - Cohort Studies MH - *Heart Failure/diagnosis/epidemiology MH - Glucose MH - Sodium OAB - In this multi-centre, registry-based analysis, the new use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in patients with atrial fibrillation and type 2 diabetes mellitus was associated with lower all-cause mortality or hospitalization due to heart failure (HF) events. All-cause mortality, HF hospitalization, ischaemic stroke, and composite renal outcomes, defined as >50% decline in renal function or new initiation of dialysis occurred significantly less in the SGLT2i new users, compared with the propensity score-matched controls. The difference in outcomes between the SGLT2i group and control group was more pronounced in patients with higher HbA1c at baseline and prior HF. OABL- eng OTO - NOTNLM OT - Atrial fibrillation OT - Clinical outcome OT - Heart failure OT - Sodium-glucose cotransporter 2 inhibitors OT - Type 2 diabetes mellitus COIS- Conflict of interest: None declared. EDAT- 2023/10/06 00:43 MHDA- 2024/02/19 06:42 CRDT- 2023/10/05 21:43 PHST- 2023/06/07 00:00 [received] PHST- 2023/09/25 00:00 [revised] PHST- 2023/09/29 00:00 [accepted] PHST- 2024/02/19 06:42 [medline] PHST- 2023/10/06 00:43 [pubmed] PHST- 2023/10/05 21:43 [entrez] AID - 7292959 [pii] AID - 10.1093/eurjpc/zwad322 [doi] PST - ppublish SO - Eur J Prev Cardiol. 2024 Feb 15;31(3):320-329. doi: 10.1093/eurjpc/zwad322.