"Effect of SGLT-2 inhibitors on arrhythmia events: insight from an updated secondary analysis of > 80,000 patients (the SGLT2i-Arrhythmias and Sudden Cardiac Death)"

作者全名："Liao, Jia; Ebrahimi, Ramin; Ling, Zhiyu; Meyer, Christian; Martinek, Martin; Sommer, Philipp; Futyma, Piotr; Di Vece, Davide; Schratter, Alexandra; Acou, Willem-Jan; Zhu, Lin; Kiuchi, Marcio G.; Liu, Shaowen; Yin, Yuehui; Puererfellner, Helmut; Templin, Christian; Chen, Shaojie"

作者地址："[Liao, Jia; Ling, Zhiyu; Yin, Yuehui; Chen, Shaojie] Chongqing Med Univ, Dept Cardiol, Affiliated Hosp 2, Chongqing, Peoples R China; [Liao, Jia] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Cardiol, Wuhan, Peoples R China; [Ebrahimi, Ramin] Zent Kardiol, Heart Clin Pratteln, Pratteln, Switzerland; [Meyer, Christian] Cardiac Neuro & Electrophysiol Res Consortium, Dept Cardiol, Angiol, Intens Care, Dusseldorf, Germany; [Meyer, Christian] DZHK German Ctr Cardiovasc Res, Partner Site Hamburg Kiel Lubeck, Hamburg, Germany; [Meyer, Christian] Heinrich Heine Univ Dusseldorf, Inst Neural & Sensory Physiol, Dusseldorf, Germany; [Martinek, Martin; Puererfellner, Helmut; Chen, Shaojie] Dept Internal Med Cardiol Angiol & Intens Care 2, Akad Lehrkrankenhaus, Ordensklinikum Linz Elisabethinen, Linz, Austria; [Sommer, Philipp] Ruhr Univ Bochum, Klin Elektrophysiol & Rhythmol Herz & Diabeteszen, Georgstr 11, D-32545 Bad Oeynhausen, Germany; [Futyma, Piotr] Univ Rzeszow, Med Coll, St Josephs Heart Rhythm Ctr, Rzeszow, Poland; [Di Vece, Davide; Templin, Christian] Univ Zurich, Univ Hosp Zurich, Univ Heart Ctr, Dept Cardiol, Zurich, Switzerland; [Schratter, Alexandra] Klin Floridsdorf Wien, Abt Kardiol, Vienna, Austria; [Acou, Willem-Jan] AZ Delta, Dept Cardiol, Roeselare, Belgium; [Zhu, Lin] Frankfurt Rotkreuz Kliniken, Kardiol, Frankfurt, Germany; [Kiuchi, Marcio G.] Univ Western Australia, Royal Perth Hosp Unit, Sch Med, Perth, Australia; [Liu, Shaowen] Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Dept Cardiol, Sch Med, Shanghai, Peoples R China; [Chen, Shaojie] Akad Lehrkrankenhaus Goethe Univ Frankfurt Main, Agaples Markus Krankenhaus, Med Klin 3, Cardioangiol Ctr Bethanien CCB,Kardiol, Frankfurt, Germany"

通信作者："Ling, ZY; Chen, SJ (通讯作者)，Chongqing Med Univ, Dept Cardiol, Affiliated Hosp 2, Chongqing, Peoples R China.; Chen, SJ (通讯作者)，Dept Internal Med Cardiol Angiol & Intens Care 2, Akad Lehrkrankenhaus, Ordensklinikum Linz Elisabethinen, Linz, Austria.; Chen, SJ (通讯作者)，Akad Lehrkrankenhaus Goethe Univ Frankfurt Main, Agaples Markus Krankenhaus, Med Klin 3, Cardioangiol Ctr Bethanien CCB,Kardiol, Frankfurt, Germany."

来源：CARDIOVASCULAR DIABETOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001177173700005

JCR分区：Q1

影响因子：9.3

年份：2024

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Sodium-glucose co-transporter 2 inhibitors(SGLT2i); Arrhythmia; Atrial fibrillation; Atrial flutter; Ventricular tachycardia; Ventricular arrhythmia; Sudden cardiac death

摘要："Objective We aimed to assess the effect of SGLT2i on arrhythmias by conducting a meta-analysis using data from randomized controlled trials(RCTs). Background Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have shown cardioprotective effects via multiple mechanisms that may also contribute to decrease arrhythmias risk. Methods We searched in databases (PubMed, Embase, Cochrane Library, and clinicaltrials.gov) up to April 2023. RCTs comparing SGLT2i with placebo were included. The effects of SGLT2i on atrial fibrillation(AF), atrial flutter(AFL), composite AF/AFL, ventricular fibrillation(VF), ventricular tachycardia(VT), ventricular extrasystoles(VES), sudden cardiac death(SCD) and composite VF/VT/SCD were evaluated. Results 33 placebo-controlled RCTs were included, comprising 88,098 patients (48,585 in SGLT2i vs. 39,513 in placebo). The mean age was 64.9 +/- 9.4 years, 63.0% were male. The mean follow-up was 1.4 +/- 1.1 years. The pooled-results showed that SGLT2i was associated with a significantly lower risk of AF [risk ratio(RR): 0.88, 95% confidence interval(CI) 0.78-1.00, P = 0.04] and composite AF/AFL (RR: 0.86, 95%CI 0.77-0.96, P = 0.01). This favorable effect appeared to be substantially pronounced in patients with HFrEF, male gender, dapagliflozin, and > 1 year follow-up. For SCD, only in heart failure patients, SGLT2i were found to be associated with a borderline lower risk of SCD (RR: 0.67, P = 0.05). No significant effects of SGLT2i on other ventricular arrhythmic outcomes were found. Conclusions SGLT2i lowers the risks of AF and AF/AFL, and this favorable effect appeared to be particularly pronounced in patients with HFrEF, male gender, dapagliflozin, and longer follow-up (> 1 year). SGLT2i lowers the risk of SCD only in heart failure patients."

基金机构："National Natural Science Foundation of China [82170520]; Natural Science Foundation Project of Chongqing [cstc2021jcyj-msxmX0075]; Program for Youth Innovation in Future Medicine, Chongqing Medical University [W0078]"

基金资助正文："No industry/financial funding for the study. Z.L. was supported by the National Natural Science Foundation of China (Grant Number 82170520), Natural Science Foundation Project of Chongqing (cstc2021jcyj-msxmX0075), Program for Youth Innovation in Future Medicine, Chongqing Medical University (Grant Number W0078)."