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SGLT2 inhibitors decrease atrial fibrillation risk in HFrEF patients

Presented by
Dr Joel Manuel Alejandro, University of Maryland, MD, USA
HFA 2024
When patients with heart failure with reduced ejection fraction (HFrEF) use an SGLT2 inhibitor, this lowers their risk of atrial fibrillation (AF) events and symptoms. This conclusion was based on a large retrospective cohort analysis.

Dr Joel Manuel Alejandro (University of Maryland, MD, USA) presented one of the abstracts featured in the Young Investigator Award (YIA) Clinical Cardiology session [1]. Dr Alejandro said that secondary data from HF trials have shown unclear findings on the effect of SGLT2 inhibitors on AF thus far. This retrospective cohort analysis utilised the multinational TriNetX Diamond Network, which consists of around 200 million patients from 92 healthcare organisations.

The study evaluated if using SGLT2 inhibitors is associated with a reduction in incidence of AF events and AF symptoms (tachycardia, palpitations, chest pain, syncope, fatigue, and weakness) in HFrEF patients. The investigators identified 2 cohorts of 54,025 adult HFrEF patients each, using propensity matching, 1 cohort on SGLT2 inhibitors and the other cohort not.

The use of SGLT2 inhibitors in patients with HFrEF was found to be associated with lower risks of:

  • AF events (OR 0.61; 95% CI 0.60–0.63);
  • AF symptoms (OR 0.52; 95% CI 0.50–0.53);
  • major CV events (OR 0.47; 95% CI 0.46–0.48);
  • all-cause mortality (OR 0.44; 95% CI 0.42–0.45);
  • myocardial infarction (OR 0.59; 95% CI 0.57–0.61);
  • cerebral infarction (OR 0.61; 95% CI 0.59–0.64).

There was no increased incidence of diabetic ketoacidosis (OR 1.00; 95% CI 0.87–1.15).

  1. Alejandro JM. Can SGLT2i use decrease the risk of atrial fibrillation in patients with heart failure with reduced ejection fraction: a retrospective cohort study. Heart Failure 2024, 11–14 May, Lisbon, Portugal.

Medical writing support was provided by Michiel Tent.
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