Background: Previous studies have suggested that Sodium Glucose Cotransporter-2(SGLT2) inhibitor may play cardio-protective role in type 2 diabetes mellitus (T2DM) patients. However, its effects on cardiovascular events for T2DM patients with atrial fibrillation (AF) have less been addressed. Therefore, we performed a large-scale multi-center retrospective study to explore the potential value of SGLT2 in the treatment of T2DM patients with AF.
Method: We thoroughly searched the IBM Explorys database for T2DM patients with AF from January 2010 to January 2015. The patients were included or excluded with strict criteria. Primary outcomes were cardiovascular disease (CVD) events including myocardial infarction (MI) and stroke happened in 5 years after T2DM diagnose. Cox proportional hazards models with propensity-score-matching were adopted to assess the effect of SGLT2 inhibitor use and CVD events.
Result: Among 1,573,330 T2DM patients, 44048(7.3%) patients were once treated with SGLT2 drugs. A total of 88,096 propensity score-matched T2DM patients were included in the analysis according to a thorough including criteria. After adjusting for age, gender, disease history, other antidiabetic drugs and anti-coagulate drugs, the use of SGLT2 inhibitor was associated with a 11% decreased risk of MI [Hazard Ratio(HR): 0.90 (95% confidence interval(CI):0.84, 0.94), p = 0.002] compare to non-SGLT2 user. However, no significant protective effect was found in stroke risk (HR: 0.94 (95% CI: 0.86, 1.03), p = 0.194). Besides, insulin was associated with increased risk of developing MI (HR: 1.09 (95% CI: 1.01, 1.18)).
Conclusion: In conclusion, our study suggests that SGLT2 inhibitor has positive effects on the control of MI for T2DM patients with AF. However, no significant effect was found for stroke risk in this multi-center cohort. More high-quality randomized controlled trials are required to confirm cardio-protective roles of SGLT2 for T2DM patients with AF in the future.
Y. Zhang: None. Y. Chen: None. J. Deng: None. P. Hu: None. Z. Tang: None. J. Mei: None. S. Li: None.