Yi-Hsin Chan1,2,3, Shao-Wei Chen4,5, Tze-Fan Chao6,7, Yi-Wei Kao8, Chien-Ying Huang1, Pao-Hsien Chu9,10. 1. The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, 33305, Taiwan. 2. College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan. 3. Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. 4. Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Linkou Medical Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, Taiwan. 5. Center for Big Data Analytics and Statistics, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan City, Taiwan. 6. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 7. Institute of Clinical Medicine, Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. 8. Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan. 9. The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, 33305, Taiwan. taipei.chu@gmail.com. 10. College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan. taipei.chu@gmail.com.
Abstract
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/m2. 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/m2, AF risk significantly increased in patients with baseline BMI [Formula: see text] 27.5 kg/m2 (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.
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/m2. 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/m2, AF risk significantly increased in patients with baseline BMI [Formula: see text] 27.5 kg/m2 (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.
Authors: Katarina Andelova; Barbara Szeiffova Bacova; Matus Sykora; Peter Hlivak; Miroslav Barancik; Narcis Tribulova Journal: Int J Mol Sci Date: 2022-01-26 Impact factor: 5.923
Authors: João Pedro Ferreira; Patrick Rossignol; George Bakris; Cyrus Mehta; William B White; Faiez Zannad Journal: Cardiovasc Diabetol Date: 2021-09-14 Impact factor: 9.951