作者
Riccardo Proietti, José Miguel Rivera-Caravaca, Raquel López-Gálvez, Stephanie L Harrison, Francisco Marín, Paula Underhill, Eduard Shantsila, Garry McDowell, Manlio Vinciguerra, Rhys Davies, Clarissa Giebel, Deirdre A Lane, Gregory YH Lip
发表日期
2023/4/11
期刊
Journal of Clinical Medicine
卷号
12
期号
8
页码范围
2814
出版商
MDPI
简介
Background
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are effective anti-diabetic drugs improving cardiovascular outcomes in type 2 diabetes mellitus (T2DM) patients. This study investigated cardiovascular, cerebrovascular and cognitive outcomes of SGLT2i therapy in patients with atrial fibrillation (AF) and T2DM. Methods
Observational study using TriNetX, a global health research network of anonymised electronic medical records from real-world patients between January 2018 and December 2019. The network includes healthcare organisations globally but predominately in the United States. AF patients (ICD-10-CM code: I48) with T2DM were divided according to SGLT2i use or not, and balanced using propensity score matching (PSM). Patients were followed-up for 3-years. The primary endpoints were ischaemic stroke/transient ischemic attack (TIA), intracranial haemorrhage (ICH), and incident dementia. Secondary endpoints were incident heart failure and mortality. Results
We identified 89,356 AF patients with T2DM of which 5061 (5.7%) were taking a SGLT2i. After PSM, 5049 patients (mean age 66.7 ± 10.6 years; 28.9% female) were included in each group. At 3-years follow-up, the risk of ischaemic stroke/TIA was higher in patients not receiving SGLT2i (HR 1.12, 95% CI 1.01–1.24) and for ICH (HR 1.57, 95% CI 1.25–1.99) and incident dementia (HR 1.66, 95% CI 1.30–2.12). Incident heart failure (HR 1.50, 95% CI 1.34–1.68) and mortality (HR 1.77, 95% CI 1.58–1.99) risks were increased in AF patients not receiving SGLT2i. Conclusions
In our large ‘real world’ analysis of patients with concomitant AF and T2DM, SGLT2i …学术搜索中的文章
R Proietti, JM Rivera-Caravaca, R López-Gálvez… - Journal of Clinical Medicine, 2023